End-of-life planning is one of the most important things we can do for our family so that they will be financially protected and supported in our absence, yet even the thought of approaching this task can feel daunting. When we hear the terms “end-of-life planning” or “estate planning” many different questions may come to mind. Does it mean writing a will? Or naming guardians for minor children? Is it putting real estate into a trust? What documents do I need? Is estate planning and end-of-life planning the same thing? When do I need to do these things? We may have a vague idea of what is involved, but as these conversations can be difficult to have, they may be put off for some other day. Unfortunately, by failing to make a plan, we may inadvertently hurt those we care about the most. It doesn’t have to be this way.
It’s ideal to consult with a financial advisor who can guide you through creating a plan that ensures peace of mind about your family’s financial future. Your estate plan will contain a number of different documents, including a health care proxy, and these all need to be customized to your unique circumstances. Some choose to tackle all of these documents at once, while others choose to create them one at a time. This does not have to be an overwhelming task when you have an advisor who is experienced in holistic end-of-life planning. What is most important is that you take action, and one of the easiest steps you can take today is to create a health care proxy.
When do you need a health care proxy?
A health care proxy is a legal document which allows you to appoint someone to make health care decisions for you if you lose the ability to make decisions yourself. This should be one of the first estate planning documents that everyone creates as early as their eighteenth birthday. Not only is it a vital component of end-of-life planning, but it may also become crucially important at other times in your life. If you or your loved ones are ever brought into the hospital in an emergency, a health care proxy can make a tremendous difference in how medical care decisions are made.
Consider the scenario: Your son is a few hours away from home in his freshman year of college. You get a call from a hospital near his school to let you know that there has been an accident, and he has been brought to the emergency department. You are only able to get minimal information about his condition over the phone. You’ve been meaning to speak with him about creating the important legal documents he should have now that he is 18, which would include a health care proxy, but with all the tasks fighting for your attention as you were getting ready to drop him off at college, you never actually did it. Thankfully, by the time you arrive at the hospital, your son is alert and gives consent for you to join him at his bedside and to speak with the medical staff. However, if his accident had been worse and he was unable to communicate, without a health care proxy it would have been much more difficult for you to be included in decisions regarding his care since he is legally an adult.
On the other hand, perhaps your mother has a heart condition and collapses while visiting with friends. They call an ambulance to rush her to the hospital. You arrive and alert the medical staff that you are named on your mom’s health care proxy. The doctor determines that her current condition has rendered your mother incapable of making her own healthcare decisions, and the proxy takes effect. You now have the legal right to make medical decisions on your mother’s behalf.
In either of these situations, a health care proxy is an important document to have.
The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) was established to protect a patient’s personal and health information. If health organizations, such as hospitals or doctor offices do not adhere to HIPAA, they can face heavy fines. This has led to strict protocols regarding the release of patient information at medical facilities. Without a health care proxy, even if you are a direct family member and know what your loved one’s wishes are, medical staff may not discuss treatment with you.
How is a health care proxy used in end-of-life planning?
Part of end-of-life planning is making decisions that can remove burden from your loved ones. Without a health care proxy in place, your wishes about your own care may not be followed. If your doctor has deemed you incapable of making your own medical decisions, they may be forced to use their own best judgement, which may or may not align with what you would want. This could place your family into a position of confusion and frustration, especially if they know your feelings about certain courses of treatment and the care you receive differs from that.
A health care proxy allows you to appoint someone you trust to be your health care agent. If you lose the ability to make medical decisions for yourself, as determined by your doctor, your agent can make sure that your wishes are followed by medical staff. When you are creating your health care proxy, you can specify how much decision-making power you want to grant to your health care agent, and you can give instructions that your agent must follow. Hospitals, doctors and other health care providers must respect your agent’s decisions as if they were your own.
When you create a health care proxy, you can make decisions about care at the end of life which may include heroic measures, circumstances under which you would or would not want artificial nutrition and hydration, and the type of treatment or support you would want if you are in a permanent coma or have a terminal illness. Through your health care proxy, you are giving your health care agent the ability to speak on your behalf in these situations as your medical condition may continue to change.
It’s important to note that there are also situations in which a health care proxy can take effect temporarily. For example, if you are under general anesthesia or in a coma from an accident, and then regain the ability to make decisions for yourself, the health care agent you appointed is no longer authorized to act on your behalf. This is why anyone in your household over age 18 should have a health care proxy.
Steps You Can Take Right Now
- Do you have an estate plan with a signed health care proxy? A comprehensive estate plan is a vital part of end-of-life planning. In addition to a health care proxy, your estate plan documents may include a last will and testament, a trust or trusts, a financial power of attorney, a living will, beneficiary designations, and a last letter of instruction. A financial advisor can review any estate planning documents you may have and can make recommendations as to others that may best suit your personal circumstances.
- If you have a health care proxy, review it. As with any estate planning documents, your health care proxy should be periodically reviewed to ensure that it accurately reflects your wishes and that your designees are up to date. For instance, if you had listed a spouse as your designee, and then divorced or legally separated, your former spouse can no longer be your agent by law, unless you state otherwise.
- What if you don’t have a health care proxy? Any member of your household over age 18 should have a signed health care proxy. There are standard health care proxies available to download by state, and your state may also have prototype forms available online. An estate attorney can help you to prepare documents that match your wishes.
- Speak with your designees. This is a big responsibility, and you should take the time to discuss your feelings about your health care with anyone you appoint as a health care agent. If your proxy goes into effect, your agent will be tasked with making decisions on your behalf throughout what may be a changing situation. Be clear on your feelings about various types of care and medical scenarios. Make sure you provide your designee with copies of your signed health care proxy.
- Maintain a digital copy in a secure online vault. When an emergency happens, you don’t want to be scrambling to find legal papers, which may be locked away in a bank’s safety deposit box or at home. Easy access, especially in an emergency, can help your loved ones navigate a difficult situation a bit easier.
- Make a list of your medications. First responders advise having a typed list of all your medications, strengths, and dosages available to provide in case of an emergency. This list should include over-the-counter medications and nutritional supplements, such as vitamins.
- Make a list of underlying medical conditions. It can help medical providers to know if a patient is diabetic, has high blood pressure, has cancer, allergies to medications, etc. Your list of medications will give medical providers quick insight into what conditions you may be under treatment for and any relevant information you make easily accessible can be a help.
End-of-life planning is difficult for any of us to think about, yet by taking steps, such as creating a health care proxy and speaking with a financial advisor who can compassionately guide us throughout the process, the more peace and security we can provide for our families. If you have any questions, please feel free to contact us.
