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Don't Leave Our Family Guessing, April's Healthcare Decisions Month Pushes For Advance Care Planning
It's almost May, but April was Health Care Decisions Month in North Carolina, a time to raise awareness about planning for the future. This includes thinking about your wishes for end-of-life care, like updating your will and health care directives.
We often assume our loved ones know what we want, but many people are unsure. Data shows nearly a third of people guess wrong about their loved ones' end-of-life preferences.
Advance care planning is the process of making decisions about your future medical care in case you're unable to speak for yourself. This helps your family act on your wishes and reduces stress for them during a difficult time.
Joining WRAL News to discuss this important topic is Risa Hanau, a clinical and community educator with Authora Care, a palliative and hospice care organization.
Hanau, what does advance care planning involve? Is it just filling out forms?
Hanau: It's actually broader than documents. There are documents like living wills, but those are just one piece. The bigger picture is having conversations - the tough ones - with loved ones, healthcare providers, and faith leaders. This helps them understand what's important to you and what kind of care you'd want if you couldn't speak for yourself.
Why is this important for caregivers too?
Hanau: Knowing your wishes helps caregivers make difficult decisions with confidence. Research shows it can improve their mental health and reduce depression during a stressful time.
In your experience, how does advance care planning benefit families?
Hanau: Having these conversations and completing documents is a gift to yourself and your family. Imagine it's 3 am in the emergency room. It's a tough situation anyway, but if your family knows your wishes, they can make decisions with confidence. That's a powerful gift.
We shouldn't wait until a crisis to talk about this. What's one step we can take today?
Hanau: Start a conversation with loved ones about what matters to you. There are also many online resources, like the Authoritas Care website and other advance care planning websites. Include your doctor in these conversations as well.
Creating An Advance Directive For Your Future Well-being
No one can predict the future, but putting together an advance directive can bring you peace of mind and a plan for your medical care during an emergency or end of life.
Dr. Maisha Robinson, chair of the Palliative Medicine Department at Mayo Clinic in Florida, advises people to have these conversations with family members and loved ones.
"An advance directive is (really) a document that allows you to write out what your preferences are," says Dr. Robinson. "It often will say, 'If you can't make decisions for yourself, who would you want to help you make medical decisions?'"
Though it may be difficult, Dr. Robinson says to have a conversation with loved ones before becoming critically ill.
Advance care planning is for people at every stage of life.
"So this is not just for people who have a serious or advanced medical condition," says Dr. Robinson. "All of us, everyone over the age of 18, really should be thinking about this and talking about this and documenting this."
There are two main parts to an advance directive: writing a will and choosing a health care surrogate, which is a person who can make health care decisions for you if you are unable to.
Dr. Robinson has three important tips after preparing your directive:
Dr. Robinson says not enough people in the U.S. Have advance directives and that African Americans are less likely to create them and receive information about them compared to white people.
"It's too often that family members are left in the situation where they have to make decisions on behalf of a loved one," says Dr. Robinson. "We often say this is one of the best gifts you can give your loved one by saying, 'These are my wishes, please honor them.'"
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Living Our Lives – And Planning For The Inevitable
May peace be with you
gettyMore than half of those with at least $100,000 in investable assets and who have retired – or are planning to do so – do not yet have an estate plan, according to an April 2024 Ameriprise report.
At a time when we are advised to consider how to live our lives while reckoning with the reality that we could all die at any moment, It turns out that we are not undertaking the hard tasks of planning for longer lives or death.
Recent news about advance medical planning, retirement stability and estate planning show that few are prepared. Approximately two of every three adults do not have an advance directive, a plan in place for when they are incapacitated or need end-of-life decisionmaking.
Under a third of Americans have a will, according to a 2024 report from Caring.Com. Almost half (43%) explain that it's because of "procrastination," a percentage that is higher than those who explain it is because they do not have enough assets.
When it comes to retirement, under one-third of those in the Ameriprise report feel confident that they will have enough money to last the rest of their lives. Approximately one-quarter don't agree on how much to spend for children and grandchildren.
It's not because couples don't have shared goals for when they retire or because they do not trust their partner when it comes to money. The Ameriprise study showed that over 90% of couples do share goals, trust one another, and are open in discussing their finances. Most (68%) find that their approach to finances is balanced by their partner. Blended families, which include the children of another relationship, however, may face distinct challenges as they consider the respective needs of their prior and current families.
Of course, some people are unable to save or save less because of their income. For people who have been invested in a 401(k) plan for ten years or longer, women's average balance was slightly less than 75% of men's, Moreover, most people who are working class do not yet have a pension, according to Deborah Carr, a sociology professor and Director of the Center of Innovation in Social Science at Boston University.
Documents that might be needed.
gettyThere is plenty of guidance on how to plan and how to save. The most basic advice is to face these realities. Regardless of income, regardless of marital status, everyone needs to consider how they want to be taken care of when they can no longer care for themselves, how they will ensure as much comfort for themselves as possible during retirement, and what will happen to any assets upon their death. A first step is creating a realistic list of any assets and projected expenses, given that retirement could last for 30 years. Even the almost half of American households between the ages of 50-64 that have under $10,000 in retirement savings accounts can take steps to increase their retirement stability, such as delaying the receipt of Social Security.
A second step is conversations with family members and close friends, making sure that wishes for care are known and documented.
A third step is involving professionals, ranging from therapists who can help with confronting the unknown to the local Social Security office to lawyers and others.
Those with assets, according to the Ameriprise study, can use financial advisors, and study participants who had consulted financial advisors overwhelmingly believed that the financial advisors has been helpful.
Deborah Gordon, a law professor at Drexel University who has worked with many different types of clients and studies family wealth, suggests that a helpful and reassuring first step is to get educated about what happens if no planning occurs: "One of the things I've found to be true—both for clients and law students—is that people frequently misunderstand the default rules that kick in when we don't do any planning for our property or care. Often, those whom we most trust or want to benefit are not the people whom the law selects, depending on where we live and how property is titled. While planning for incapacity and death can be overwhelming, it also can be empowering, especially with the right help."
Taking control of long-term planning makes us better able to confront the drumbeat of headlines on what might happen if we don't plan.
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