Broker Check

Revise Your Estate Plan to Cover Health Care Directions

| December 01, 2015
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When Jay's motorcycle accident left him unconscious and on life support, his family had to make the difficult decision of keeping the life-sustaining machines on or turning them off and allowing Jay to die. Jay's wife thought he'd prefer the latter, while Jay's parents wanted to hold out and see if he'd wake up.

This unfortunate family debate didn't have to take place. It could have been avoided if -before the accident - Jay had included his wishes in his estate plan using a living will and a health care power of attorney (HCPA).

Defining the documents

To ensure that your wishes are carried out, and that your family is spared the burden of guessing - or arguing over - what you would decide, put those wishes in writing. Generally, that means executing two documents: 1) a living will and 2) a health care power of attorney (HCPA).

Unfortunately, these documents are known by many different names, which can lead to confusion. Living wills are sometimes called "advance directives," "health care directives" or "directives to physicians." And HCPAs may also be known as "durable medical powers of attorney," "durable powers of attorney for health care" or "health care proxies." In some states, "advance directive" refers to a single document that contains both a living will and an HCPA.

For the sake of convenience, we'll use the terms "living will" and "HCPA." Regardless of terminology, these documents serve two important purposes: 1) to guide health care providers in the event you can't communicate and are terminally ill or permanently unconscious, and 2) to appoint someone you trust to make medical decisions on your behalf.

A living will expresses your preferences for the use of life-sustaining medical procedures, such as artificial feeding and breathing, surgery, invasive diagnostic tests, and pain medication. It also specifies the situations in which these procedures should be used or withheld.

An HCPA authorizes a surrogate - your spouse, child or another trusted representative - to make medical decisions or consent to medical treatment on your behalf when you're unable to do so. It's broader than a living will, which generally is limited to end-of-life situations, although there may be some overlap.

Working in tandem

When Jay's motorcycle accident left him unconscious and on life support, his family had to make the difficult decision of keeping the life-sustaining machines on or turning them off and allowing Jay to die. Jay's wife thought he'd prefer the latter, while Jay's parents wanted to hold out and see if he'd wake up.

This unfortunate family debate didn't have to take place. It could have been avoided if -before the accident - Jay had included his wishes in his estate plan using a living will and a health care power of attorney (HCPA).

Defining the documents

To ensure that your wishes are carried out, and that your family is spared the burden of guessing - or arguing over - what you would decide, put those wishes in writing. Generally, that means executing two documents: 1) a living will and 2) a health care power of attorney (HCPA).

Unfortunately, these documents are known by many different names, which can lead to confusion. Living wills are sometimes called "advance directives," "health care directives" or "directives to physicians." And HCPAs may also be known as "durable medical powers of attorney," "durable powers of attorney for health care" or "health care proxies." In some states, "advance directive" refers to a single document that contains both a living will and an HCPA.

For the sake of convenience, we'll use the terms "living will" and "HCPA." Regardless of terminology, these documents serve two important purposes: 1) to guide health care providers in the event you can't communicate and are terminally ill or permanently unconscious, and 2) to appoint someone you trust to make medical decisions on your behalf.

A living will expresses your preferences for the use of life-sustaining medical procedures, such as artificial feeding and breathing, surgery, invasive diagnostic tests, and pain medication. It also specifies the situations in which these procedures should be used or withheld.

An HCPA authorizes a surrogate - your spouse, child or another trusted representative - to make medical decisions or consent to medical treatment on your behalf when you're unable to do so. It's broader than a living will, which generally is limited to end-of-life situations, although there may be some overlap.

Working in tandem

It's a good idea to have both a living will and an HCPA or, if allowed by state law, a single document that combines the two. A living will typically details the procedures you want and don't want under specified circumstances. But no matter how carefully you plan, a document you prepare now can't account for every possible contingency down the road.

That's where an HCPA comes in. Although an HCPA can include specific instructions, it can also be used to provide general guidelines or principles and give your representative the discretion to deal with complex medical decisions and unanticipated circumstances (such as new treatment options).

This approach offers greater flexibility, but it also makes it critically important to appoint the right representative. Choose someone whom you trust unconditionally, who is in good health, and who is both willing and able to make decisions about your health care. And be sure to name at least one backup in the event your first choice is unavailable.

Revising your estate plan

Before an illness or an accident, consult with your advisor to revise your estate plan to include a living will and HCPA. Without these documents, your loved ones may have to make medical decisions on your behalf without any guidance. Your tax professional can explain the legal and tax consequences of these particular strategies.

Make your plan accessible

No matter how carefully you plan, your living will and health care power of attorney (HCPA) are effective only if your documents are readily accessible and health care providers honor them. Store your original documents in a safe place that's always accessible and be sure your loved ones know where they are. Also, keep in mind that health care providers may be reluctant to honor documents that are several years old, so it's a good idea to sign new ones periodically.

Content written by Thomson Reuters, as distributed to Symmetry Partners, LLC. Our firm utilizes Symmetry Partners, LLC for investment management services. Symmetry Partners, LLC, is an investment adviser registered with the Securities and Exchange Commission. The firm only transacts business in states where it is properly registered, or excluded or exempted from registration requirements. All data is from sources believed to be reliable, but cannot be guaranteed or warranted.

Different types of investments involve varying degrees of risk, and there can be no assurance that the future performance of any specific investment, investment strategy, product (including the investments and/or investment strategies recommended or undertaken by Symmetry Partners LLC), or any non-investment related content, made reference to directly or indirectly in this article  will be profitable, equal any corresponding indicated historical performance level(s), be suitable for your portfolio or individual situation, or prove successful.  Due to various factors, including changing market conditions and/or applicable 

. A living will typically details the procedures you want and don't want under specified circumstances. But no matter how carefully you plan, a document you prepare now can't account for every possible contingency down the road.

That's where an HCPA comes in. Although an HCPA can include specific instructions, it can also be used to provide general guidelines or principles and give your representative the discretion to deal with complex medical decisions and unanticipated circumstances (such as new treatment options).

This approach offers greater flexibility, but it also makes it critically important to appoint the right representative. Choose someone whom you trust unconditionally, who is in good health, and who is both willing and able to make decisions about your health care. And be sure to name at least one backup in the event your first choice is unavailable.

Revising your estate plan

Before an illness or an accident, consult with your advisor to revise your estate plan to include a living will and HCPA. Without these documents, your loved ones may have to make medical decisions on your behalf without any guidance. Your tax professional can explain the legal and tax consequences of these particular strategies.

Make your plan accessible

No matter how carefully you plan, your living will and health care power of attorney (HCPA) are effective only if your documents are readily accessible and health care providers honor them. Store your original documents in a safe place that's always accessible and be sure your loved ones know where they are. Also, keep in mind that health care providers may be reluctant to honor documents that are several years old, so it's a good idea to sign new ones periodically.

Content written by Thomson Reuters, as distributed to Symmetry Partners, LLC. Our firm utilizes Symmetry Partners, LLC for investment management services. Symmetry Partners, LLC, is an investment adviser registered with the Securities and Exchange Commission. The firm only transacts business in states where it is properly registered, or excluded or exempted from registration requirements. All data is from sources believed to be reliable, but cannot be guaranteed or warranted.

Different types of investments involve varying degrees of risk, and there can be no assurance that the future performance of any specific investment, investment strategy, product (including the investments and/or investment strategies recommended or undertaken by Symmetry Partners LLC), or any non-investment related content, made reference to directly or indirectly in this article  will be profitable, equal any corresponding indicated historical performance level(s), be suitable for your portfolio or individual situation, or prove successful.  Due to various factors, including changing market conditions and/or applicable laws, the content may no longer be reflective of current opinions or positions. The article contains the opinions of the author(s) but not necessarily Symmetry Partners, LLC.  Please note that you should not assume that any discussion or information contained in this article serves as the receipt of, or as a substitute for, personalized investment advice from Symmetry Partners or your advisor.

Please be advised that Symmetry Partners, LLC does not provide tax or legal advice and nothing either stated or implied here should be inferred as providing such advice. The information is provided for educational purposes only. Please be advised that Symmetry Partners is merely relaying this information and has no control if some of the timelines are amended.

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