The first in a two-parter: What you need to know but wish you didn’t

I recently read an article entitled, How Doctors Die, and was struck by its simplicity and elegance.  Also, I was struck by how doctors know what they want and don’t want, clearly, because they aren’t afraid to face death, the inevitability of it, and the need for anticipation and planning.  Tomorrow, we’ll talk about another article I read recently, What Would Happen if you Died Tonight, and how we can better plan for our own inevitable demise.  But today, let’s start with the cheery subject of the end of life decisions doctors make, and how we (unfortunately) differ.

First, they plan.  Necessarily, as a doctor, they see and comprehend in a way us regular folk cannot (except perhaps funeral directors) that death is inevitable. Not only that, and perhaps more importantly, they understand that not planning very likely means that things will happen to you and around you that you do not ever want to happen.  Procedures will be done to you that you would have refused if you could have, your family will suffer more than they should, you will suffer in pain and illness more than  you would choose to, and your estate (your money, your assets) will be in a tangled mess, causing more hardship on your family than you would ever have wanted.

We don’t want to think about death – no one does – but the reality is inevitable.  We don’t have a choice about that.  What we DO have a choice about is how we handle it, the dignity we grant ourselves, the burdens and responsibilities (or lack thereof) we leave to our loved ones, and the mess (or lack thereof) we leave to our loved ones.  If we have these choices, and it’s really the only choices we have in our anticipation of death, then why don’t we take advantage of them?

Second, doctors know of and learn from our mistakes.  It can be hard to acknowledge our own mortality unless and until we either experience serious illness or we see it in one of our loved ones.  But we can learn from their wisdom, and we don’t have to necessarily experience it to benefit from what they see.  Illness, accidents, & terrible diagnoses don’t generally come with advance warning and the ability to prepare.  They come on suddenly, shockingly, and require grave decisions to be made, sometimes quite quickly.  But the best time to make a decision is when you are calm and able to think all of the issued out.  The worst time?  When you’re facing a life or death situation.

The bottom line is that planning is essential to ensure that you are cared for in the way you want to be, and that you do not put unnecessary burden on your loved ones.  If you knew what the burden would be when it came time, you would definitely choose to plan ahead.  Why wait until it’s too late?

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Beyond estate planning: Long-term care insurance

When I work with my clients to complete their estate plans, including their living trust, their powers of attorney, their wills, and other documents, I talk to them about other areas of their life where they should “get their affairs in order.”  One of these areas are long-term care insurance.  While this is not a service that I provide personally, I consider it part of my job to at least alert my clients to the other areas of their life that may need attention in preparation for retirement and beyond.  Many individuals just don’t have the correct information to be able to make informed decisions, so I try to bridge these gaps so my clients can make the best decisions for them.

Long-term care insurance is insurance that helps to pay for your care as you get older.  Very few of us are going to go from healthy and active one day to dead the next.  Most of us will decline more slowly as age starts to take its toll on our bodies.  Perhaps driving or climbing stairs will become difficult, and then perhaps we’ll need to use a cane or walker.  Medicare will not help you unless and until you are housebound and confined to your bed (generally).  During that phase of your life where you are slowing down, if you don’t have long-term care insurance, you have two options:  you can pay for it ($20,000/month or more) or depend on your family and friends to help take care of you.  Not many older individuals have an extra $20,000/month to spare, so paying for it is nearly impossible.  Depending on family can be an option for some, but I think many who have the ability to think about it ahead of time do not want to place this burden on their family.  Even those who cringe at the thought of having a stranger come into their home can understand the need for their caregiver family member to have a break from the care giving.  Long-term care insurance helps to pay for in-home care (or assisted living), can help to relieve family care givers, and help to save your finances when you can’t work anymore.  If you get it at a young age, it’s quite reasonable to pay for, and both you and your family will be grateful you had it.