It is a basic human desire to be in "control" of our lives and most of us have a strong need and desire to feel independent. Nevertheless, your independence may be threatened as you go through the natural process of aging, face a progressive illness or deal with a medical emergency. At some point, you may become totally or partially dependent on others and as a result, your loved ones may be confronted with needing to make some very important and difficult decisions.
While you can't predict the specific circumstances of a future event, most people have a sense about what is important to you when it comes to medical or custodial care. You might know what you want, but have you communicated this to your loved ones? How will you know what your spouses, parents or siblings want or need if we haven't asked them? It is the process of communicating your most important needs and desires to the people you love that allows you to retain a semblance of control and independence during difficult times.
The conversations you have with family members are not one-time events. Each separate conversation is part of a process that maintains open communication. It's important to begin talking now, not during a crisis. It may be desired to include as many loved ones in the process as possible, but recognize not everyone will feel comfortable talking and not everyone will agree. Hopefully, everyone can listen with an open heart and open mind.
We have found an excellent resource called The Conversation Project. They provide tools and ideas dedicated to helping people talk about their wishes for end-of- life care. You can find them at www.TheConversationProject.org . We recommend you download their Conversation Starter Kit which outlines a process that is easy to use, respectful and thoughtful. Here are some Starter Kit discussion points:
- When you think about the last phase of your life, what's most important to you?
- Do you have any particular concerns about your health or about the last phase of your life?
- Who do you want (or not want) involved in your care? Who would you like making decisions on your behalf if you are not able to? Is this person is identified in your health care proxy or living will?
- Would you prefer to be actively involved in decisions about your care? Or would you rather have your doctors do what they think best?
- Are there any disagreements or family tensions that concern you?
- Are there circumstances that you would consider worse than death (Long-term need of a breathing machine, feeding tube or not being able to recognize your loved ones)?
- Are there important milestones you would like to achieve if possible (The birth of a grandchild, your 80th birthday or a charitable gift)?
- Where do you want (or not want) to receive care (Home, nursing facility or hospital)?
- What kind of aggressive treatment would you want (or not want) (Resuscitation if your heart stops, breathing machine or feeding tube)?
- When would it be okay to shift from a focus on curative care to a focus on comfort care alone?
- What affairs do you need to get in order or talk to loved ones about (Personal finances, property or relationships)?
These topics are just conversation starting points. While it is vital to discuss your hopes and desires, it is equally important to make sure your wishes can actually be carried out. Are there obstacles that need to be discussed? For example, if your objective is to stay in your two-story home forever, what will happen if you can't safely climb the stairs to your 2nd story bedroom? Is it possible to install a lift and would you be able to afford to renovate your residence to accommodate these needs? If you need assistance with activities of daily living, like bathing, dressing, eating, continence, toileting and transferring, who will help? Will a spouse, child, niece, nephew or neighbor be willing or able to help? Can you afford to pay a professional for these services?
Many of these conversation points will have both financial and legal considerations. Here are a few that should be addressed:
- Are your wills and trusts updated and do they reflect your current goals and objectives?
- Have you told loved ones where they can locate estate planning documents, bank, investment and insurance information?
- Have you confirmed the beneficiary designations for life insurance policies, retirement accounts and annuities?
- Does somebody else know how to access your financial and social websites?
- Who should your heirs contact if they have questions about your financial affairs and do you have a designated power of attorney?
We recommend choose someone to act as the "quarterback" for all your financial, estate, and health planning needs. The quarterback might be a family member, your financial planner, lawyer, designated executor, power of attorney or someone else whom you can trust. The quarterback should be considered a vital resource when it comes to organization and access to financial information. He or she should be able to work directly with family members, insurance agents, attorneys, and accountants and be able to help resolve many of the practical issues related to the family's objectives.
The "conversation" is the first-step in gaining a sense of security that you and your loved ones are able to retain control and independence during a potentially difficult period. Good planning can help retain family harmony and provide an important legacy to multiple generations. Don't be afraid to sit down with your family members, tell them you love them and help them plan for their future.
If you need someone to help facilitate these conversations, The Raskin Planning Group can serve in this role or provide a list of resources for you.
Peter Raskin is a registered representative of Lincoln Financial Advisors Corp. Securities and investment advisory services offered through Lincoln Financial Advisors Corp., a broker/dealer (member SIPC) and registered investment advisor. Insurance offered through Lincoln affiliates and other fine companies. The Raskin Planning Group is not an affiliate of Lincoln Financial Advisors. CRN-1709094-021317