End-of-Life Planning is Important

Kenny Rogers famously crooned, "The most that you can hope for is to die in your sleep." Unfortunately, while death comes for all of us eventually, we can't guarantee it will come so painlessly or gently. As difficult as it is to contemplate, we should all think about end-of-life care.

Most of the time, when people talk about estate planning, they are talking about what they expect to happen after they've died. But an important part of estate planning is making sure one's wishes are known for medical care in the event of incapacity and designating a trusted person to make sure those wishes are honored and carried out.

Two dangerous assumptions that many people make is that they have plenty of time to talk about these issues with loved ones, and that even if they don't, their loved ones will know what's best to do. These assumptions too frequently prove to be tragically false.

Who Needs End-of-Life Planning?

A sudden accident or rapid-onset illness, like a stroke, can strike an adult of any age. When that happens, the victim is often unable to communicate his or her wishes for care. With advances in medical technology, patients who once would have died might now be kept alive for weeks, months, or years. The question is: at what cost, and what benefit is achieved? And what measures should be taken, or withheld?

Think about these questions for a moment:

• If you were in a coma with virtually no chance of recovery, would you want to be kept alive by artificial means?
• What if there were a very small, say, 5% chance of some recovery, but uncertainty as to how much function you would recover, and a likelihood you would need extensive care for the rest of your life?
• If you would not want to be kept alive, would you want to have nutrition withheld, or simply not have extraordinary measures taken if those were necessary to keep you alive?
• Do you know how your spouse, sibling, or parent would answer these questions, and would you feel comfortable making these decisions for them without their input?

Many people struggle with the first three questions, but nearly all are caught short by the last. Consider that. If you would be uncomfortable making these decisions for someone else, chances are they would feel the same about making them for you. Wouldn't you find it comforting to know, with certainty, their wishes? Realize that, again, they would feel the same—and it's in your power to grant them that comfort.

Essential Documents for End-of-Life Planning

What documents should you have in place for end-of-life care? The following is a list of common end-of- life planning elements you may wish to include:

• Living will: This document, which you can modify or revoke at any time, communicates to your loved ones what life-sustaining treatment you do or do not wish if you are unable to communicate, and two physicians agree your condition is not likely to improve.
• Health Care Directive: This document allows the person you designate (agent) to make health care decisions on your behalf if you are unable to do so. You can revoke or modify this document at any time until you are incapacitated.
• HIPAA release: This form allows your health care providers to disclose your medical information to people you choose.
• Do Not Resuscitate (DNR) form: This document allows you to define and limit the health care you would receive in an emergency. This is revocable at any time. It is also in the nature of a medical order, and is separate from a living will. You do not need to have a DNR unless you want one; you should always have a living will.
• Organ Donor Registry form: This document may be part of your living will, and declares whether you want to be an organ and/or tissue donor. You may also make this declaration when renewing your driver license.
• Declaration for Funeral Arrangements: This document lets you identify someone you want to make your final arrangements, and may guide them as to your wishes regarding those arrangements.

In addition, you may want to do some financial planning around your end-of-life care. Such care can be expensive. In addition to sparing your loved ones the emotional burden of guessing your wishes, you can also minimize their financial worries when they should be focused on more important things. Consult an experienced Ohio estate planning attorney to discuss what documents you need—then take the important step of discussing your plans with your loved ones.