Healthcare Planning: Why Not to Wait

By , June 18, 2010

How a $75 piece of paper can save you a boatload of trouble.

I was recently hired by a gentleman who found himself in a difficult circumstance.  Not all that long after he and his wife had cashed their first Social Security checks, his wife had begun to show signs of forgetfulness, and in the span of just a few months had descended into moderate dementia.  I was consulted to help get her affairs in order while she was still able to participate in the process, and I recommended all of the things I would recommend to any senior: a Durable Power of Attorney, Appointment of Health Care Representative, Living Will, and Last Will, but I made one more suggestion that threw him for a bit of a loop:

I suggested that getting his own health care plans in order was more important.

That’s not to say that this was the more pressing issue, but a healthy spouse’s plan does have broader consequences than a sick one’s, and it’s not hard to see why.  In my client’s case, once the wife becomes unable to manage her finances and care, everyone – the hospitals, the family and the courts – will be looking to him for answers, and he’s more than capable of giving them.  Should the husband have an automobile accident, or a fall, or a serious illness, however, he’s asking for an express ride down the rabbit hole in the healthcare decision process.

First, a hospital will be looking to his wife for decisions, and they may need an answer well before they’re able to ascertain that she can’t give one.  Once they do, they’ll look to the kids, but if the kids don’t agree, the courts may need to become involved.  And if, someday, a decision is needed about terminating life support, and one child gets court approval against the wishes of another, well…that circumstance has torn more than a handful of families apart.

For healthy, happily married couples, these risks remain.  If you’re in an accident together, or as age begins to complicate things, you may end up appreciating the alternate decisionmaker that is pretty much standard in most advanced directives.

Unlike the bread and butter of estate planning – wills & trusts – advanced directives are usually very reasonably priced and very stable.  They don’t need to be redone if the Internal Revenue Code is updated or your child’s marriage ends, and they’re not likely to be invalidated by upcoming changes to the probate code.  So long as you remain happy with the people you’ve chosen, the documents should remain useful.

As a practitioner of estate planning, it would be negligent for me to suggest anything less than a comprehensive asset review and estate planning consultation with your attorney.  However, if you have no desire to do that, or at least to do it right now, spend a couple hundred dollars and get your advanced directives in order, even if you don’t think you need them yet.  They won’t get any cheaper or less important in the future.

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