There's no easy way to start discussing end-of-life issues. It's normal for people to experience all sorts of emotions.
Fear about your future and the future of family and friends is common. So is a sense of acceptance and resolve to enjoy the remaining days. Different people respond differently. But there's one piece of advice that's generally good for everyone: it helps to be prepared.
The legal system is frequently called on to address end-of-life care and issues. One of the major concerns arises when people become incapacitated in their old age and can no longer make their own decisions.
Healthcare decisions still need to be made, and loved ones must manage financial affairs. These issues are important, and you can benefit from proper planning.
General Health Care Decisions
Healthcare decisions are a sensitive subject. As people grow older, they may lose the ability to make decisions and communicate them to doctors and family members.
Doctors often have opinions about what should be done from a medical point of view, while family and friends may struggle to determine the best course of action. However, you can plan for these types of situations.
Care Needs and Various Care Settings
Older adults and their loved ones should discuss if they want to be cared for at home or eventually live in a nursing home. There is a range of assisted living facilities and different levels of care services. It is possible to find a solution that provides the feeling of independence while protecting their well-being.
Families should also discuss approved healthcare providers, clinical trials, and how to handle a terminal illness. Older patients may only want treatment from certain care teams and clinicians but turn down care options from others. This can be especially true in advanced cancer patients.
Palliative Care Basics
Palliative care is health care for serious or life-threatening illnesses that focuses on the following:
- Medical care for symptoms and pain relief
- Treatment to cure the illness
Palliative care is often used when doctors focus on the quality of life more than healing an illness. Patients can choose to continue treating the illness or focus only on symptom management during palliative care.
Caregivers may need to make difficult decisions during this time if the older adult is not conscious or able to make decisions.
Hospice Care Basics
Like palliative care, hospice is often used as end-of-life care for seriously ill older adults or those with a short life expectancy.
It focuses on the person's quality of life and aims to keep them as pain-free and comfortable as possible. Unlike palliative care, hospice doesn't aim to treat the illness.
Loved ones can struggle to make hospice and end-of-life decisions for older people, so it can give them peace of mind to have any end-of-life wishes listed clearly in legal documents.
Giving Decision-Making Power to Someone Else
There are some advanced care planning tools you can use. These legal documents can help everyone prepare to deal with healthcare-related end-of-life issues:
- Advance directives (not legally binding)
- Living wills or health care directives (legally binding)
- Power of attorney for healthcare
- Financial power of attorney
- Living trusts
Prepare an Advance Health Care Directive
An advance healthcare directive is a non-binding document that contains your healthcare wishes should you become incapacitated. People often use advanced health care directives to specify:
- What kind of medical treatments they want to receive
- Whether they'd prefer to be in a hospital or care facility
- Issues such as organ donation and artificial life support
An advance health care directive sets out your wishes for doctors and family members to refer to later. It's relatively easy to prepare but generally isn't binding. This means it isn't always legally binding when a doctor has an objection to your wishes.
Prepare a Living Will
A living will is a binding document that serves the same purpose as an advanced health care directive. A living will contains your directions for your care – whatever they might be.
Many people use a DIY living will to direct doctors to withhold treatment at a certain stage. Other people direct their doctors to use all possible means to extend their life.
A living will differs from an advance health care directive in that it is legally binding, meaning your doctors are legally required to follow your wishes.
Grant a Power of Attorney for Healthcare
You might prefer to appoint someone to make care decisions for you. Granting a power of attorney for healthcare to someone you trust will empower them to make decisions on your behalf.
A power of attorney for healthcare can be detailed and drafted to specify your wishes — much like with an advance healthcare directive or living will.
It's commonly used to give decision-making power to an unmarried partner or friend. It is useful for anyone who otherwise wouldn't have the authority to make these decisions for you.
Planning for Financial Decisions
Managing property and finances can become challenging near the end of your life. Bills, taxes, investment decisions, and business considerations never cease to pile up.
Yet many people lose the ability to handle their affairs or lose track of them as healthcare decisions take priority. You can prepare to deal with these issues as well.
Giving someone durable financial power of attorney is an option. If you become incapacitated, a designated person can manage your financial affairs.
They will be able to take actions like:
- Pay bills and taxes in your name
- Manage your real estate and investments
- Access your financial records
- Buy insurance for you
- Collect retirement benefits
- Pay for health insurance
Creating Trusts and Handling Costs
You may also want to consider creating a living trust. Trusts are flexible accounts that pool together assets managed by an appointed trustee. You can specify how things should be done and appoint someone you trust to manage it as the trustee.
Whether your loved one creates a trust or not, everyone must discuss long-term care costs. The healthcare system is expensive, whether it involves assisted living, hospital stays, or at-home care. Many people can find help through Medicare or Medicaid, but there will be other non-covered costs.
Your loved one can make decisions about their body after death. Having clear afterlife wishes takes some pressure off the family and provides peace of mind that they honored their loved one.
There are costs involved with funerals, celebration of life ceremonies, burial, and the paperwork and processes after someone passes away. Discussing how these costs are handled before a loss is helpful.
Legal Help When Starting the Process
If you need help developing an estate plan or setting out your health care wishes, it's best to consult an attorney specializing in estate planning law.
You can still run into issues or unclear decisions even when your family has written documents. You can speak with an older adult law attorney if your family is focused on broader concerns.