Share what matters

End-of-life wishes and documents are one of the conversations you can have today

See the resources at the end of this article for links to important documents and forms you might need.

COVID-19 reminds us that we don’t know what the future will hold. We may not have the chance to say or do everything we intend to. If there’s anything important to share with loved ones, it’s a good idea not to delay.

For some, this will include sharing sincerely with loved ones what they mean to you. Showing your care also involves letting them know your wishes if you are incapacitated and cannot speak for yourself. This will make a difficult time easier on them, and can give you peace of mind knowing your pets, finances, health care and other matters will be taken care of.

More than a will
Most people know they should prepare a will that outlines their wishes after death. There is another important set of documents for when you are still alive.

These “end-of-life” documents may come into effect if you suffer a coma, seek inpatient treatment for mental health or a substance abuse disorder, or enter hospice near the end of life. Even though you are still alive and in some cases may recover, you could be incapable of communicating or managing your affairs for a period of time.

End-of-life documents do two important things: They make your wishes known, and they empower others to take action according to those wishes. You get to choose a trusted person who will serve on your behalf. This person is then referred to as your “proxy,” your “agent,” or your “attorney-in-fact”—these terms are used interchangeably. You can also identify alternates in case your first choice is unavailable.

Choose someone you trust as your agent
Your agent is someone you trust to speak for you and make decisions on your behalf in two basic areas: health care and finances. After you prepare a document that gives them permission, your agent can be given access to your medical records and other accounts to help them support you. Some people choose the same person as their agent for both health care and finances, while others may choose a different person for each role.

A spouse, an adult child or a close friend can all be good choices to serve as your agent. You should pick someone as your first choice, and also one or more alternates in case your first choice is not available. Keep in mind, your doctor and care team cannot serve as your agent.

Once you have selected your agent and alternates, you should sit down and talk with them. Ask them if they are willing to be your agent, and share what responsibilities they will have and what your wishes are. If you have started a draft of your documents, you can share those. Give them an opportunity to ask questions and take notes. They may bring up things you haven’t thought of.

If you do not know what topics to cover when clarifying your wishes, that’s okay. You can look online or ask your doctor for a document template that will walk you through it.

Put it in writing: Health Care Documents
The first step is to make your health care wishes known. There are many different names for health care end-of-life documents, such as Advanced Directive, Living Will, POLST and Durable Power of Attorney. Don’t worry—you don’t have to fill out all of these! Most of them serve the same purpose.

PacMed recommends starting with the short Advanced Directive form available on our website. This form is only two pages and accomplishes the two most important things: It provides you with simple health care wishes to choose between, and has the legal force to empower the person you chose to serve as your health care agent to act on your behalf.

You can update or add to this with a more complex document if your wishes expand or change in the future. But getting this simple form on file now after a conversation with your agent means you will have immediate support if the unexpected happens.

After you complete any health care document, first sign it in front of a notary or two witnesses. Then make copies and share them with those who need them. Your doctor and your health care agent both need copies of your signed and finalized health care document. Keeping another copy on file at home and even posted on your refrigerator can help emergency personnel if they need to come into your home. You may also want to send a copy to your lawyer and your county assessor’s office for them to have on file.

After the short Advanced Directive is complete, you can always replace this with a more encompassing document, if you wish, such as the long Advance Directive from Providence’s Institute for Human Caring, a Durable Power of Attorney (DPOA) for Health Care, or a medical living will. Resources on these other types of forms are recommended in the sidebar.

Put it in writing: Financial Documents and Digital Assets
After your health care documents are on file, you may also want to think about other things. If you were incapacitated, who would pay your bills, including your rent or mortgage? Who would feed your pets and let your job know?

You need someone you trust to help manage your finances if you are not able. This person will serve as your “Financial Agent.” Their responsibilities could include working with your insurance and accessing any work or state benefits you may be due. If you stop receiving income, they may need to access your savings or liquidate assets to pay for your care. Having someone responsible help with your finances can keep your life in good working, until you may recover and return home.

Some people ask the same person to serve as both their health care agent and their financial agent. Or, if your situation is more complex, you may want to choose one person to manage your health care decisions and a different person to manage your finances.

In order for your financial agent to act on your behalf with your bank, landlord, government agencies and more, you will need a strong legal document, known as a Durable Power of Attorney (DPOA) for Finances. This means the financial agent you choose will have power to act as your attorney-in-fact, another word for agent. “Durable” simply means the document will endure after you become incapacitated.

Banks have been known to refuse some DPOAs, so you might ask your bank if they have a template they recommend. You can also find starting templates online through services like RocketLawyer or LegalZoom, or have an attorney prepare the document for you. Make sure your DPOA is prepared for your state, since each state has different requirements.

Think about digital access when preparing your DPOA. So much of our business is transacted online these days, you will want to give your agent the power to use your online accounts. Make a plan for them to access your logins and passwords. Some ideas are to keep your password list in a safe deposit box, in a file in your home, or sign up for an online password service that provides “digital legacy” or “inheritance” features.

If you choose to have one person serve as your agent for everything—both health care and finances—then you don’t need two separate legal documents. You can prepare one Durable Power of Attorney document that covers both areas. In either case make sure the documents are clear and all your bases are covered. This will help your agent(s), health care providers and others avoid confusion.

Once your Durable Power of Attorney is complete, make it official the same way you did for the health care documents—have them notarized or witnessed, and share copies with your agent(s) and alternates, lawyer, county assessor’s office, and health providers if the DPOA covers health care. Keep a copy for yourself at home and posted on your refrigerator as well.

Final thoughts
When you die, the documents above all expire. To share your wishes about what happens with your money, property and body after your death, you also need to prepare a Will or Trust.

Rather than feeling daunted by the process, remember you can always update these documents later if you change your mind. You don’t have to be perfect.

The most important thing is to get started. Most who go through the process of completing their end-of-life documents find it empowering in the end.

We can feel a burden lifted once we put our wishes down on paper, and enjoy life more knowing things will be taken care of.