Aging Parents Have Health Directives–(Health Care Proxy, DNR etc.) Now What?

Dentist’s vetting Aging Teeth-2 post not back in time. Thus, thoughts about Tuesday’s NY Times’ New Old Age Column “Where is That Advance Directive?” generates this replacement post.

Much time, thought, and energy–under the best of circumstances–go into planning end-of-life directives. In the olden days this no doubt consisted primarily of a will. Today, in our more complex society, additional important aspects of Estate Planning impact not only who is beneficiary of our worldly goods after death, but–on earth– our very life itself.

4 previous posts have addressed aspects of this subject: Health Care Proxies, Do Not Resuscitate orders, Power of Attorney, family disputes, remarriage to name some. The October 17, 2013 New Old Age column focuses on bringing one’s advance directives to the  hospital.

We never know when something serious could happen that sends us to the hospital; and I doubt any of us keep advance directives in our purses, wallets, or smartphones. Thus, this New Old Age column (which instructs us to give copies to our primary care doctor, “health care decision-makers” and keep copies for ourselves) is worth the quick read.

Check out the related posts below, especially noting the importance of adult children’s knowing where important end-of-life papers are (or–conversely–if parents don’t want adult children to have this information ahead of time, how to handle it).

Related: The Astors and Us
                12 Key Pieces of Information Children of Aging Parents Should Have
                Aging Parents, Adult Children: Control and End-of-Life Issues
                Aging Parents and Emergencies: First Responders, 911, Hospitals

                Acute and Critical Care Choices Guide to Advance Directives
(Am. Assn. of Critical Care Nurses) Excellent!
Copy and Google
(it downloads from Google much faster than linking from our blog)

Changing weekly: “Of Current Interest”(right sidebar). Links to timely information and research from top universities about cancer, dementia, Parkinson’s, plus some free and some fun stuff–to help parents age well.



The Astors and Us

Media attention is focused on the Astors this weekend: Brooke, the elderly–now deceased–mother, her old adult son, and his adult son…three generations whose current situation might have been astonishing to imagine several decades ago.

Today things we assume to be rock solid or think could never happen, surprise us. I got to thinking about end-of-life issues—about my Dad and I discussing what I needed to know because I was his healthcare proxy (also called healthcare representative). I thought about problems that developed among siblings I know after parents died and the will was read. I wondered if there is a way to reduce that potential for conflict among family members, assuming the family members get along well to begin with.

I spoke with an attorney, a friend who has practiced trust and estate law for many decades and has excellent instincts about family relations. He says it’s better if adult children know certain things ahead of time: for example, who will be trustee or have power of attorney. That prevents second-guessing the rationale after the will is read. He advises parents to bring adult children into the process (assuming they are responsible in the ordinary sense) so they are not “left in the dark.” At the minimum, he suggests that adult children know:

1. who the key advisors are (accountant, banker, casualty and life insurance agent, doctor, lawyer, and stock broker)

2. where the important documents are located.

If this isn’t possible or desirable, adult children should at least know whom to contact. And lastly, ideally adult children should also know if there is a living will and in general what the will provides.

He continued with this idea which I really like: Parents who don’t want to discuss anything with their children ahead of time can write a letter, separate from any formal estate documents, explaining his or her thinking when the will or estate planning was done. It should be kept with other important documents with instructions “Not to be Opened Until My Death.”

To go a step further, I know of instances among my friends, where the mother dies and the father remarries. I imagine you do too. Then the father dies, leaving his adult children’s relationship with the second wife in shambles. The reason: wills that seem (and perhaps are) unfair to the father’s biological children. Could a letter, assuming a direct conversation before his death was too uncomfortable, be helpful?

We talked about second marriages. “Situation that include children from other spouses literally cry out for careful thought and planning, to be carried out by expertly-prepared life and estate-planning documents,” he counseled.

If our parents haven’t discussed anything with us yet, do we have the kind of relationship where we can initiate something? Can we use this post as a springboard for discussion?

Perhaps the above thoughts and information can help avoid some of the pitfalls.