For Clients, Community and Advisors.
I’ve spent 30 years counseling clients in making choices and giving
directions concerning durable powers of attorney for health care and end
of life treatment. In the last week, I came face to face with the inevitable
decisions that families of my clients have been forced to make. Being
a “client” makes me more aware of the very real gut wrenching
decisions that families have to make every day. I should explain.
Two weeks ago, my 85 year old father was to have a minimally invasive aortic
valve replacement and a stent put into an artery. We were delighted we’d
found a young surgeon whose “niche” was this type of surgery.
Unfortunately, once the operation started, they discovered that the blocked
artery would not take the stress and he had a conventional “open
heart” surgery. He subsequently got pneumonia and other complications
and has been in intensive care for the last two weeks. I just spent a
week in Tucson where they live helping my mother and coordinating his care.
Dad was on a ventilator on at least three occasions. Over last weekend,
they recommended that he have a tracheotomy so that they could deal more
effectively with the pneumonia. You see, my Dad would never want to live
unable to talk or eat. That is not the quality of life he would want.
My Mom was certain of it. But, also, Dad is a fighter. He wouldn’t
want us to give up. Should Mom consent to placement of the tracheotomy?
His health care power of attorney gives her the authority.
I insisted that we consult with the surgeon who stated emphatically that
we were not at a futile point. After a very difficult afternoon of phone
calls with my sisters, Mom decided to consent to the procedure (which
was performed yesterday without incident). We hope that the “trache”
will allow him to recoverf from the pneuonia quickly and get him on his
way to recovery. It will certainly be a long, slow road.
What lesson can I offer my clients and their advisors from my own family’s
recent experience? Of course, it is important to have a durable power
of attorney for health care. That determines who gets to make the final
decision. It also gives some general direction on end of life care.
But, most importantly, talk to your spouse or your agent about what you
would want and, perhaps even more importantly, what you would not want.
(Some of our clients, for example, don’t ever want to be put in
a nursing home. Others don’t want to be given psychotropic medications.)
The durable power of attorney is only a starting point. We are pleased
to add any and all specific directions clients want in their health care
power. Our objective is to customize your estate plan to exactly what you want.
More and more of our clients have annual reviews of their estate plans
with our firm. This is the case exactly and precisely to ensure that their
important and current objectives are incorporated into their plan. In
the end, we want their estate plans to work just as they wanted.