October is Financial Planning Month, and having a solid financial plan is more than just investments and savings. Preparing for all life stages, including death, is an important part of your financial planning to support family and friends who care about (and may provide care for) you. Regardless of whether you are a “send me gently into that good night” or a “balls to the wall, I’m squeezing out every last second” sort of person, there are some things that everyone should consider and have in place.
First up, your Medical Orders for Life-Sustaining Treatment (MOLST) form. While most people equate this with those last days in old age, the truth is that this form could apply to anyone if the circumstances warrant it since it governs what we want to happen when we become seriously and potentially terminally ill. If the Pandemic taught us anything, it’s that you can become seriously ill unexpectedly and at any age. Your MOLST form is a way of communicating to the medical field your treatment preferences concerning life-sustaining treatment. Among other things, it can be used to communicate Do Not Resuscitate (DNR) or Do Not Intubate (DNI) instructions outside of a hospital setting.
Next up, what’s the status of your Power of Attorney? To clean up a few issues, New York State changed the Power of Attorney (POA) form again this year. If you have an older one, it should still work but if you have an extremely old one, consider adding that To Do to your 2023 list. This is also a good time to evaluate WHO you have as your Power of Attorney. The unfortunate truth of the matter is that the majority of financial theft comes from inside the family (to channel all sorts of classic movies), so it is important to understand the power you are bestowing on someone. Perhaps your POA is a parent who has now aged and may not be up for the challenge of being a POA. Another possibility is that your children were too young when you originally drafted your documents and one or more of them is now old enough to take over the responsibility. At the very least, you should have a conversation with your existing POA designee and make sure they are still OK with the responsibility.
Filling out our “Last Chapter” trifecta is the Health Care Proxy, which may or may not be combined with a Living Will. This is the form that appoints someone to be your Health Care Agent and puts them in charge of making healthcare decisions for you if you are unable to make those decisions for yourself. Coarsely, in layperson’s terms, this is the form that allows someone to pull the plug, but it also empowers that person to help make you comfortable if you can’t easily communicate your needs, decide whether or not (using your MOLST for guidance) to authorize treatment, and communicate your intentions to the vast and varied number of people, professional and not, who will intersect your life during this period of time.
To put this all into a neat little bundle – your MOLST outlines what you want done, your POA empowers someone to pay for things while that’s being done, and your HCP give someone the power to do the things you want done. Make a bunch of copies, seal them in envelopes, and distribute them to a variety of people who will be able to produce them when needed. One attorney even recommends writing a little note on your Drivers License to give emergency medical providers a heads up that you have specific intentions.
As we head into fall and seasons change – I am reminded that the medical field changes (some would say “advances”, but I’ll hold judgement on that for a while longer), our thoughts about our wants change as we learn more about our options, and the people we’ve entrusted with various powers change, some maturing into being responsible enough to handle the situation and others out of our lives. As all of those pieces move around, how we communicate our intentions needs to be updated to reflect those changes. As I’ve said so many times, the big issue is Talk, Talk, Talk. Have a conversation with your nearest and dearest about your intentions and wishes, go about your life, and then have another conversation with your nearest and dearest. As we age, as we watch the world around us, and as we witness and help other people through challenging times, our own wishes and intentions can change and that’s OK. What’s not OK, is not telling the people who are potentially going to have to make some tough decisions on our behalf.