When it comes to making health care decisions, most of us are able to tell our doctors and family members what we do or do not want. Unfortunately, this may not always be the case. What if you had a
Documents You Will Need One of the most important things you can do for the people who mean the most to you is prepare for after you are gone, as difficult as that process may be. Having your financial affairs
The Veterans’ Benefits Administration (VBA) provides an integrated program of veterans’ benefits. These include compensation for service-connected disabilities, pensions for war-time veterans with non-service connected disabilities who meet income criteria, benefits for burial, home loans, survivor pension benefits and life
Caregiving: Advance Care Planning for a Friend
A difficult but important aspect of caring for a friend is preparing for her or his end-of-life stage. While not an easy issue to think about, planning well in advance for end-of-life care can help protect your friend’s well-being and provide peace of mind for everyone involved.
People usually have strong preferences about how they would like to live in the final stages of life and what types of care they do and do not want. It is very important to involve your friend and any family members in these conversations and decisions. The following questions may be helpful for your friend to consider.
Dealing with the death of a friend is never easy. The emotional impact alone may be more than enough for you to process. When you add to that the myriad logistical responsibilities that come with a friend’s passing, making decisions can become overwhelming. This summary describes several items you should consider to help relieve some of the burden and prepare you for the future. Some additional terms and legal situations may arise as you navigate your friend’s end-of-life events. Click on the terms below to learn more.
Make sure advance directives are in place, including a Living Will and A Health Care Power of Attorney, which are described in more detail in Important Legal and Financial Documents. Give copies to the key people involved in your friend’s life (with his or her permission.) You will want to make sure that your friend has a will and that you know its location.
Probate assets are assets that people hold in their own names at time of death. These assets pass on to heirs according to terms of a will, subject to court supervision.
The probate process often entails delays and costs, but some estate planning strategies can be used to mitigate those drawbacks by passing assets to heirs outside of probate. These strategies include joint ownership, beneficiary designations and transfer on death designations. (Trusts can also be used for this purpose.)
Nearly all financial institutions allow the account owner to indicate (designate) the person or persons to whom to transfer the asset upon the owner’s death. People can make such designations for retirement accounts like 401(k)s and IRAs, and for annuities and life insurance policies.
All beneficiary designations need to be kept up to date. Failure to update beneficiary designations may result in life insurance, defined contribution accounts or Individual Retirement Account (IRA) balances getting paid to the wrong individual.
When they specify a beneficiary, the assets will pass to the beneficiary outside of probate. (Note that beneficiary designations take precedence over any provisions in a will.) Many people name primary and secondary beneficiaries, so that if the first beneficiary dies before the owner, there is no question about who the new owner will be.
Along with the emotional toll, a funeral can exact a huge financial toll as well. In 2019, the average cost of a funeral was $9,000. For help planning and strategizing for this expense, read Transamerica’s article on average funeral costs and how to plan for them. According to the American Bar Association, reports consistently show that on average that families who plan in advance for funeral arrangements, spend less than families that wait until the need arises. You can pre-plan with or without pre-paying. If an application for SSI or Medicaid is likely, ask a consumer advocate about the options for pre-paying funeral expenses before applying. The rules on this vary from state to state, but most states do not count a qualified pre-paid funeral as an asset for Medicaid or SSI.
Palliative care and hospice also provide options for end-of-life care. Palliative care addresses the needs of patients who have chronic and/or life-threatening illnesses but are not likely to die soon. It is a medical specialty that enhances the individual’s overall comfort and quality of life by providing a wide range of services.
Hospice is a holistic approach to caring for people who are terminally ill. It involves a team of trained professionals, available 24 hours a day, who provide medical attention, pain management, and emotional and spiritual support tailored to an individual’s needs and wishes. Both in home, and inpatient hospice care is available in most communities, allowing the choice of the best care option for the person. Medicare, Medicaid, and most private insurance cover the costs of palliative care and hospice care. It is often helpful to ask health care providers if palliative or hospice care is appropriate (many are reluctant to suggest these care options.)
For taxable accounts held at brokerage firms, the owner of the assets may want to have the brokerage set up a transfer on death (TOD) provision. Some bank accounts use TODs, too. A TOD acts like a beneficiary designation, so the assets pass directly, outside of probate.
Business ownership is another area for special consideration. The owner will want to plan carefully who will run the business upon the owner’s death. Specialized life insurance may need to be factored into the transition, so that ownership will transfer with minimal disruption. The assistance of a good attorney can be important to the outcome.
There are also many toolkits and resources designed to guide caregivers through the processes of having conversations with their friends, helping friends identify their healthcare and financial preferences, and caring for individuals with specific diagnoses. Below are some toolkits for these different parts of advance care planning.
|Resource||When would I use this resource?|
|Guide to Having Tough Conversations with Your Loved Ones||This guide from a Place for Mom gives caregivers comprehensive tips on starting sensitive conversations such as health, financial, and legal planning.|
|CFPB’s “Managing Someone Else’s Money” guides can help you understand your role as a financial caregiver, also called a fiduciary. Each guide explains your responsibilities as a fiduciary, how to spot financial exploitation, and avoid scams. Each guide also includes a “Where to go for help” section with a list of relevant resources. The Guides are available in English and Spanish.|
|Your Guide to Being a Health Care Proxy||The Conversation Project’s free Conversation Guides help caregivers have conversations with important people in their lives that they care for. This particular guide walks a caregiver through the process of being a health advocate for someone a loved on. Guides are available in English, Spanish, and Chinese.|
|For Caregivers of People with Alzheimer’s or Other Forms of Dementia||The Conversation Project’s free Conversation Guides help caregivers have conversations with important people in their lives that they care for. This particular guide helps caregivers understand what matters most to someone living with a form of dementia, and help them have a say in their health care. Guides are available in English, Spanish, and Chinese.|