Mar 31, 2010

Advance Directives -- Part Two, The Wild Ride Continues

When I last wrote, my father was still alive, and I was in the midst of making decisions that were murky and difficult. He passed away on February 28, 2010. It wasn't possible to write (or shop, or really do much of anything else) during his final illness. But now I can catch up and share some of the things that I learned about the whole process.

As I said in my earlier blog post, being someone's health care agent is a BIG DEAL (to quote, sort of, our Vice President). You need to really know what the principal (the person who appointed you) wants, and doesn't want, if they become critically ill.

As an estate planner with young, healthy clients, I really didn't dwell on what making an end-of-life choice in your Advance Directive means. But I will now. Before my Dad died, I guess I imagined that end of life choices would be stark: there'd be the car crash or the stroke. There'd be no brain activity and it would be obvious that maintaining life support wasn't what the person wanted. Guess what? That's the easy scenario. Real life is way weirder than that.

My father got the one-doctor-says-you're-cured; one-doctor-says-goodbye; one-doctor-says-you're-stable; but NO ONE SAYS you're terminally ill treatment in the hospital. He was told he had a rare neurological disease. He was told that he could take a drug that cost $5,000 a dose for five day straight, every three weeks, for 2 years (!), and maybe he'd see some improvement. My father was almost 83 at that point, had lost more than 30 lbs in the last year, and was completely weakened by the disease.

He couldn't swallow safely. Food got into his lungs. That turned into pnuemonia. He ended up with a feeding tube. He could have lived for awhile that way, but at what cost? In a nursing home? Never getting out of bed?

Every scenario is, of course, different. But if you're acting as an agent for someone you love, talk to them. Right away. Make sure you know what's important to them and what they're willing to put up with and what they don't really want. Don't assume you'll get the easy choice; assume you'll get the hard one.

To learn more about advance directives and health care agents, see Plan Your Estate, by Denis Clifford (Nolo).