Saying final good-byes to loved ones is one of the most difficult parts of the human experience. These good-byes can be infinitely more difficult when the one saying good-bye is saddled with the responsibility of making end-of-life decisions for someone who can no longer communicate his or her wishes. The legal system has come up with a document to help give incapacitated individuals a say in these decisions. Most states call this document the Living Will or the Advance Directive. It is the most depressing multiple choice test you will ever take, as it poses a variety of end-of-life situations and asks the signer to indicate their wishes for each situation. This document is often combined with a medical power of attorney, depending on which state you live in.
The Advance Directive received a lot of attention around the turn of the century when a young Florida woman named Terri Schiavo went into cardiac arrest at her home and, due to lack of oxygen to her brain, ended up in an irreversible persistent vegetative state. Terri’s case received national attention because she had not signed a living will and a disagreement emerged among her husband and her parents about whether to continue providing her with hydration and artificial nutrition. Terri’s condition deteriorated over time, but the disagreement did not, and so she was kept alive. Eventually a judge had to call a group of Terri’s friends and family members together to ask them about anything Terri might have said through the years about how she felt about being kept alive by a series of machines. All told, Terri spent fifteen years in a vegetative state before finally passing away in March of 2005. Her case involved 14 appeals and a variety of State Court motions, five federal court cases, and four denials by the U.S. Supreme Court.
To illustrate how this process works on the other end of the spectrum, I would like to share with you the story of my father. My dad updated his estate documents in 2009 and, after talking with his attorney about the Advance Directive and his intentions, he then shared these intentions with his wife and children. A decade later and several years into his Alzheimer’s diagnosis, my father aspirated food into his lungs, pneumonia developed, and my mother, myself, and one of my brothers found ourselves meeting with a palliative care team discussing whether to continue life support or to focus on dad’s comfort. The decision was unanimous and made without hesitation – we knew exactly what he wanted because he had told us. My father eased the hardest moments of our lives because he sat down and spoke with us about his intentions, long before the dementia was even on the horizon.
Our planning team spends hours talking with families about all the little (and sometimes big) financial decisions that impact their lives. Having recently said good-bye to my own father, I can tell you firsthand: the dialogue about his end-of-life intentions was more valuable and important than anything we ever discussed about money. The conversation when Dad filled out the Advance Directive was uncomfortable, but that little bit of uncomfortableness spared my family a lifetime of wondering if we had done what he wanted when he was no longer able to communicate those wishes. If you do not have an Advance Directive, you ought to put it on your New Year’s resolution list. If you have any end-of-life or other planning-related questions – or if you need help facilitating these conversations with the next generation in your family, please reach out to our team.