The Decisions Families Should Make Before Care Becomes Urgent

Planning for some parts of our lives is fun.  

Family vacation? That sounds fun! Let’s make a plan.

Following a diet and exercise plan to get healthy? Aspirational!

Planning to invest regularly for eventual retirement? Sign me up!  

What about the less fun parts, though? The parts that we hope to not need, like planning what types of life support you are prepared to accept?  

Not fun in the least, which is why so many of us do not plan for the parts of life in which we could need the most care.

Here’s what you can do about it – you can make some of these plans right now, before the need is urgent. How? By thinking about, documenting, and discussing a few decisions for yourself with your loved ones.  

Decision #1: Who is the designated power of attorney?

Who do you trust to have your best interests at heart? You, our Principal in this discussion, may have more than one designated Attorney-in-Fact (AIF, or agent), for example, if you have one person for financial power of attorney and a different person for healthcare decisions (more on that later). You also can appoint co-agents, and you can even specify that the agents can act independently or must act together, but that can complicate matters later.  

With all of these options, imagine how confusing it would be for your family or loved ones to try to act on your behalf if they have no guidance or information from you! And there could be multiple people who love you (lucky you!) who may think they ought to be involved. There could be a care power struggle, for lack of a better term. All of this potential conflict just creates more strife and more stress in the event that you need an agent to handle affairs for you.

The other option, luckily, is that you can have conversations and set plans for Power of Attorney agents in place ahead of time via documentation. Which brings us to the next decision that will come up in the documentation phase.

Decision #2: What powers are granted to the Attorney-in-Fact?

A financial power of attorney document typically includes an explicit list of powers that the Principal will grant to the named agent. This can include banking activities like paying bills or opening accounts, stock and bond transactions, business transactions, real estate transactions – you name it. Literally.

It is important to consider the implications of granting or not granting certain powers. This is your time to be detailed and ask questions if needed about how the agent can or cannot act on your behalf given the powers delegated.

For example, let’s say that your Power of Attorney is not granted the power to self-gift out of your accounts. This can be considered if the agent pays a bill on your behalf and then plans to be reimbursed. At best, the reimbursement may need an extra documentation step to show that it is not a gift. At worst, the reimbursement may not be allowed, and the Attorney-in-Fact would need access to pay your bills directly if you cannot do that yourself. All of this is fine, but it may be a detail that you, the Principal, need to consider.  

Decision #3: In terms of healthcare, how much and what types of care am I comfortable with receiving?

Just as financial power of attorney documents includes lists of possible powers to grant, a document called an advance healthcare directive will include a list of potential healthcare measures that you can use to direct (hence the name) your future care.

Imagine for a moment this nightmare scenario – there has been an accident and you, dear Principal, are unconscious and unresponsive. The Emergency Department will stabilize you, but then the healthcare team has questions. Do you want extraordinary lifesaving measures to be used if needed, and if so, which ones? Can they intubate you to let you breathe with a ventilator if you cannot on your own? What about a feeding tube? For how long do you want this care? What about assisted coma treatment?  

Now imagine that your loved one is answering these questions without knowing what your wishes are. Can you imagine the additional stress and trauma these decisions could place on your loved ones? To go back to Decision #1, which person is even in charge?

This is where an advanced healthcare directive can be especially helpful. It allows you to make these decisions for yourself and record your selections. It alleviates some of the uncertainty and guilt in healthcare decision-making for your loved one, because you have given them the cheat codes by doing it yourself.  

Making these decisions may seem daunting or unpleasant – these are not the fun plans that we enjoy! That’s why thinking about the outcomes, what could happen if we avoid these plans too completely, can be instructive and encourage you to spend some time with the decisions families should make before care becomes urgent.  

Let’s talk

Naming an agent and documenting your wishes can make a difficult moment clearer for the people you love. Conscious Wealth can help you consider how these decisions fit within your broader financial and legacy plan and coordinate with your estate-planning attorney when needed.

Get in touch to begin the conversation >>

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