“The future depends on what we do in the present.”
— Mahatma Gandhi Political ethicist and
One of the most difficult choices a person will have to make in his or her lifetime concerns end-of-life care. While it’s a subject that few enthusiastically embrace, it can bring about immediate peace of mind. Should it be ignored, however, it can cause immeasurable stress to grieving loved ones.
These were some of the key points made by Joplin attorney Matt Adrian while addressing dozens of Joplin-area seniors Tuesday morning about advance care planning and specifically what a person should do legally — when the moment that everyone fears and dreads suddenly arrives — to ensure their wishes are honored during hospitalization.
Estate planning, the preparation of tasks that serve to manage one’s assets, exists for two reasons, Adrian said — if a person is suddenly incapacitated or dead, or when “you are no longer able to say what you would do while everyone in the room needs to know that. So how to (effectively) communicate that before you ever get to that position is what estate planning is.”
Adrian explained what would happen to an individual or a family should estate planning be ignored. If a people do nothing, or if they “choose not to choose” and don’t fill out a detailed living will, then all decisions concerning their hard-earned assets — how they are is divided and what happens to them — will be made by strangers.
State law, Adrian said, shows in black-and-white print what exactly happens to one’s belongings should a person decide to do nothing.
“What this means is you have an estate plan (already) set for you, should you choose to do nothing. Would you like to know who has set that for you? How much do you trust your state Legislature?” The question was met by skeptical laughter. “They have chosen your estate plan, not you.”
And for the most part, it does what a person normally would do: “It tracks what you would do, it just doesn’t do it the way that you would do it, that’s for sure,” he said. “If you didn’t leave a will, the probate court still has an instruction sheet — it’s just coming from the (Missouri) Legislature.”
Plus, allowing the state to assume this responsibility means money and time — the more assets, the more state-mandated costs, and what assets do reach loved ones will take time to do so, he warned.
Bottom line: “You are beholden to someone else. Well, not you. You’re dead, remember. Your heirs, the people you left behind to inherit your stuff ... will have to follow instructions from someone other than you.”
Care and treatment
What about your care and treatment in a hospital?
“If you do nothing to prepare for your incapacity and/or disability, that time while you’re still alive but unable to help — maybe you’re under anesthesia or in a medically induced coma or on a ventilator — the Legislature’s got your back,” Adrian said. “But remember, they are the ones making the decisions about you.”
Adrian said people can prepare in order to ensure there are few headaches or heartaches when it comes to the division of assets, which can include houses, cars, stocks, artwork, life insurance, pensions and debt.
Adrian said it’s important for a person to have a durable power of attorney, which authorizes a trusted loved one or family member to handle various decisions on your behalf. It remains in effect even if you become incapacitated, such as through illness or accident.
These durable powers of attorney can also help you plan for medical emergencies and declines in mental functioning and can ensure that your finances are taken care of, he continued. Having these documents in place helps “eliminate confusion and uncertainty when family members have to make tough medical decisions on your behalf.”
It’s a good idea to have one in place, he said — just in case.
Another key estate planning document is a durable power of attorney for health care, or a living will.
“Sort of what you are saying is, ‘Hey, look, doctor, with all of these (health-related) decisions, I’ve got this — I’ve already made this call.’ So we’re talking end-of-life stuff now — we’re talking about feeding tubes, we’re talking about ventilators, we’re talking about just how much you would choose to have done when there’s no reasonable likelihood of a return. These are hard decisions, decisions that human beings don’t want to make about other human beings. So what we have done with this (living will) is that we have made it so you get to say, not to just the physician but you’re saying to your family members, ‘When it gets to this point, I’ve already made that decision; you don’t have to do that.’”
“These are the vehicles you use to communicate” your health care-related wishes, Adrian added.