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We Have to Talk About Medical Advance Directives

Written By Gary S. Williams, CFP®, CRPC®, AIF® and Nicholas Ibello, CFP®, AIF® February 5, 2019

Here are some important medical advance directives you want to have in place before a crisis.

Talking about life support, nutrition, hydration, pain medication, resuscitation in the event of a horrible injury or illness can be uncomfortable and possibly emotional, but it’s important to talk about and document your wishes with your family.  Although none of us want to talk about the morbid idea of being on life support, every adult should do it.  If you’re reluctant or saying to yourself “my spouse or my parents will take care of this” then you probably didn’t hear the recent news story surrounding Khloe Kardashian and Lamar Odom. In short, Lamar Odom, a former NBA player, was hospitalized and then slipped into a coma. It was then revealed that even though they were divorced, Odom’s ex-wife, Khloe Kardashian, was responsible for making his medical decisions. Although the two had filed for divorce, it was not finalized at the time of his hospitalization due to a backlog in the courts, and Odom did not have a living will. Therefore, Kardashian (his ex-wife!) was left to make critical medical decisions on his behalf. Could you imagine your ex-spouse making end-of-life decisions for you?! Just in case you don’t have an ex-wife, let me say it another way: If you were in the hospital and the doctors were 50/50 on whether you would pull through a life-threatening illness, would you want to decide who determines if you stay on life support? I would hope your answer is “YES!”  If it was “no,” you can stop reading this now. On the other hand, if you answered, “YES!” or even just “yes,” please read on.

Here are some important medical advance directives you want to have in place before a crisis.

Living Will

A living will is written legal instructions that outline your medical care preferences should you be unable to make those decisions yourself. In the case of a terminal illness, coma, late-stage dementia, or end of life, this document lets doctors and caregivers know what choices to make that will align with what you want. A living will let the people around you know what you want and relieves them of the burden of making vital decisions.

Healthcare Proxy

A healthcare proxy is a legal document that allows you to assign another person the power to make health-related decisions for you if you are incapacitated. The person you name in the document will have the same rights to request or refuse treatment that you would if capable of making and communicating decisions.

Durable Power of Attorney

A durable power of attorney (DPOA) is similar to a healthcare proxy in that it names a person to make medical decisions for you if you are unable. However, this person will also have the power to make banking decisions, sign social security checks for you, apply for disability, and write checks from your account to pay your bills if you become unable to do these things.

With a DPOA, you can assign different people to act on your behalf for specific affairs. For example, one person can be designated the DPOA of healthcare or medical power of attorney, similar to the health-care proxy, while another person can be made the legal DPOA. 

Once you have these advance directives in place, be sure to update them when anything that affects them changes such as:

  • Divorce or separation
  • A change in your health or treatment
  • A person named as a proxy moves away, dies, or is no longer willing or able to serve;
  • You move to another state

Visit the for more information on this topic.

If you are still reading this (hopefully you are) and if you have not put these affairs in order, you are likely saying to yourself something to the effect of “this is important; I should do this.” The unfortunate reality is that you probably will not do anything about it for some time. Your life is probably busy and you think “there are more pressing matters to deal with than this.” You will need it to “hit home” before you do something about it.  Perhaps you will see your parents going through the need for these documents.  Or perhaps a friend is disabled and his family is left to make decisions. I urge you not to wait for one of these situations to prompt you. Instead, get a Post It® and write down “contact estate planning attorney.  Get my affairs in order.” Keep that post it in the middle of your desk until you get it done. You will be happy you did and your loved ones will be grateful if they are ever left in the unfortunate role of making life and death decisions on your behalf.