End of Life Issues

We all have denial about dying. End of Life issues can divide and bankrupt your family. Plan now in case you end up seriously ill.

I have had several conversations about estate planning and last wishes lately with clients. A client today said she sat down with her daughter, who is a nurse, and went over line by line the clients wishes should she ever be in the last stages of life.  I think it is such an important topic, that I suggested she record a video for her 4 children so there was no misunderstanding.

In the US, the total health care expenses in 2016 was $3.4 TRILLION. According to Kaiser Health News, in 2011 Medicare spent $554 billion and 28% of that number or $170 billion was spent on the patients last 6 months of life. That doesn’t even include the enormous amounts spent by families for home healthcare, travel to specialist, co-pays and the list goes on and on. Even after spending $170 billion PLUS the patient was still dead. (Remember – last six months of life)

I know of a gentleman with Alzheimer’s. His wife was his primary caregiver and as is common, she predeceased him. The children stepped in to take care of their father but as is also very common, when it became over bearing they hired caregivers. (I have a client whose family hired round the clock caregivers – not nurses – at a cost of over $8,000 a month for over a year.) When the gentleman contracted pneumonia, he was rushed to the ICU. The children were then split over this “exit event”. Two children wanted to do everything possible to keep their dad alive and two children wanted to make him comfortable and let him go.  The out of pocket care for their dad, who had Alzheimer’s, was over $250,000.  The daughter believes her dad would have been horrified to watch that much money being spent to keep him alive.

This gentleman had a will and a Living Will. He thought he had done everything he needed. But they had not discussed his explicit wishes for this end of life situation.

In a 2014 lecture Dr. Michael Mitchell said “When someone is dying, there is no such thing as a functional family”

Every person should have a Last Will and Testament, Health Care Power of Attorney with Advanced Directives (including the Living Will) and General and Complete Power of Attorney (Durable) as a start. There are advanced planning tools that deal with this issue explicitly.

I watched my father die of bladder cancer almost 12 years ago. My mom, sister and I knew what his wishes were, and he passed peacefully, with the help of wonderful people from Hospice, at home in his bed.

Please plan ahead and spare your family the pain of making those decisions in a very stressful emotional time. It may be the most loving thing you can do for them.