Extraordinary advice goes beyond finances
The COVID-19 pandemic has renewed the focus on healthcare decision-making. Over the past two years, countless families and individuals have had to make critical and urgent decisions about medical care for their loved ones. The consequences of these decisions are enormous, and too many people have found themselves unprepared, not knowing what types of interventions are desired or not, how to balance aggressive treatments with comfort and quality of life, and when to stop maintenance. of life.
Granted, your clients probably all have a living will and power of attorney for health care, as most estate planning attorneys include them as part of their service when creating a last will. Yet how many of your clients have been guided to think seriously about their health care wishes, and how many have passed this information on to the proxies they have appointed to make decisions for them? In honor of National Healthcare Decisions Day on April 16, can you help them do more?
Here are the steps you can follow:
- Pose the following scenario: “If you had an accident today and ended up unconscious in the emergency room, someone would make the treatment decisions for you. Would you like it to be the overworked ER doctor who never met you? Would you like your family to argue about your care and get the treatment your loudest, most stubborn family member wants you to get? Or do you want to stay in control as much as possible, make your decisions known even when you can’t speak for yourself, and choose the person who will represent your interests? I know you have a basic power of attorney for health care and a living will from the state, but I think it will serve you and your family better if we review those documents to make sure that they protect you and keep you under control in any way you want. ”
- Then go to the living will itself. Question number 1 for your clients: “What is quality of life for you?” Much like finances and inheritance, it digs deep into what they want and why, uncovering their ultimate goals and vision for themselves: to use artificial means to extend the life of your body, and when. , if so, is it no longer worth it? Some people want every known intervention to keep their body alive for as long as possible. Most people have some kind of limit, whether physical, cognitive, psychological or otherwise. What belongs to you, if anything? »
An example to get them thinking: a woman decided that if she is at the point where 50% of the time she no longer recognizes her family, she no longer wants artificial interventions and instead wants to live the best and most comfortable life possible. until her body comes to a natural death. This decision, conveyed to his family and power of attorney, frees them from arguments and guilt over whether to tell doctors to insert a feeding tube when dementia robs him of the ability to swallow or that she just stops eating. She does not want to extend the life of her body to this quality and she accepts the process of natural death.
Another possibility: A cancer patient said that if chemo cycles had a minimal effect on quality of life, but had debilitating side effects on his quality of life, he wouldn’t want another cycle of chemo unless there is at least a 75% chance that it will increase the length of his life. three times as long as the duration of the chemo itself and his remaining time would be at a quality of life that would allow him to get out of the house, walk, go to social activities and visit his little ones -children.
Get your clients thinking about what they would want in these and other scenarios, so they can provide clear advice to their families and doctors. In addition to your prompting, a great tool to help them think about these things is The Conversation Project. The site has videos, questions and resources, including a starter kit for family discussions about health care decisions.
- Once clients have refined and clarified the treatment they want and why they want it (their quality of life wishes), then confirm that the health care proxy is someone they trust to fulfill these specific wishes. Also, make sure they have at least one alternate, in case that person can’t or won’t serve at the time. Many couples appoint a spouse, for example, but what if they have an accident together and can’t serve? So who?
Emphasize the importance of trusting these people to carry out your wishes as directed. If your client wants all available treatments, would their proxy voluntarily do so even if they personally thought the treatments were futile? Conversely, if your client wanted to refuse or disconnect treatments, would their proxy do so even if they personally believed that trying all possible interventions was the best choice? Due to the emotions involved in these actions, many people decide to appoint non-family members who can fulfill their wishes more objectively. Customers need to be able to trust their attendants.
Next, the crucial step for your client is to inform their power of attorney and alternates, giving them a copy of their detailed living will, perhaps with an additional word document attached that explains the reasoning behind these decisions and the quality of life they wish to maintain. Too many proxies know they are appointed but don’t understand wishes well enough to interpret any situation in light of the “why” behind the wishes.
All in all, do more than just provide forms. Encourage thought, reflection and sound decision making. Then do what you can to ensure that clients convey those decisions to their families, caregivers, and healthcare professionals, so everyone is on the same page. You’ll avoid untold nightmares for everyone involved.
Also, remember that their decisions have far-reaching implications for their finances. Your knowledge of their wishes may result in different product amounts like long-term care or disability insurance, or a restructuring of the portfolio to better ensure that their wishes can be funded. Have those discussions. They serve you, your customers and their families.
Amy Florian is the CEO of Corgenius, combining neuroscience and psychology to train financial professions to build strong relationships with clients through all of life’s losses and transitions.