A Family Discussion That May Just Keep the Peace

Ben Franklin once said, “….but in this world nothing can be said to be certain, except death and taxes”. This quote has been repeated for over 200 years, and it has a certain ring of truth to it. While we may not know what tax rates will be in the future, we likely have some idea as to which taxes we’ll pay . . . and we can’t avoid them all. But when it comes to death, while it is often difficult to predict when we’ll meet our maker – be assured it will happen someday. I know this is a tough subject to discuss, I get it, but this is a topic that must be addressed. And you know, there’s no better time than the Holidays to address it, when we’re together with loved ones and can have candid discussions face to face.

A very nice woman from Sandwich came to see Jen and I last week; I’ll call her Mary. She is also an avid reader of this column and tunes into our radio show weekly. Mary really needed some help. You see, her husband of 40 years, John, had recently just passed away. John had done a good job of managing their finances, and luckily Mary wouldn’t suffer financially. But in addition to grieving over John, she had also been dealing with a lot of family stress. Mary and John have two sons and a daughter who live nearby and were very close to John. When John was diagnosed with Alzheimer’s disease a few years back, it progressed very quickly and he wasn’t able to make decisions for his care. Mary stepped in to make decisions for him but was met with resistance from their adult children about the best way to care for him. Her sons were adamant that he remain in his own home in his final days, where’d he had lived for over 35 years. However, Mary’s daughter felt that the strain of caring for him would be too great for Mary and the fighting ensued.

Mary did end up hiring outside help to let John spend his last days at home. She didn’t want to intervene in the children’s conflicts, but they did escalate in John’s final months. Her daughter and sons continued to quarrel with each other over other things too, like, what to do if John became acutely ill? Should they perform life-sustaining measures, or allow him to die on his own terms, with dignity intact? What would his funeral service look like, and will it be a private burial? It’s these kinds of issues that John and Mary failed to discuss before it was too late, and the stress it created during this trying time could have been avoided.

Folks, it didn’t have to happen like this. Sitting down to discuss these topics as a family could have ensured everyone knew what to expect should one of them fall seriously ill or not be able to make decisions for themselves.

So, with Christmas passed and New Year’s in our sights, let’s spend out time together this week to discuss some things we may want to consider to help us to take control of the circumstances surrounding our end of life.

Develop a living will. While Massachusetts is one of only a handful of states that do not allow legally binding living wills, a living will can help health care providers and the courts make decisions about your medical care. A living will spells out what your wishes are regarding ventilators, heart shocks, and other interventions if you’re sick, and can be very helpful.

I know it’s hard to think about something like this being necessary, but think of John, who couldn’t remember Mary’s name or even feed himself as his disease progressed. Would you want extraordinary measures done to keep you alive? Would you want to be treated for pneumonia (a leading cause of death in the U.S., especially in the elderly)? Or, just made comfortable and allowed to pass away?

A health care proxy is a must. This document outlines who you want making decisions for you if you’re incapacitated. Talk about it. I’ve known of families where the kids had exact opposite opinions about what they thought dad wanted everything done to keep him alive. You can’t have it both ways. Someone will have to make a decision, and relationships can fracture over it. Be sure and sit down with your loved ones and make your wishes clear. I recommend doing it with at least two family members and have them write out your wishes so you’re sure they understand.

Consider where you want to die. At home? In a nursing home? This decision will affect those who love you and may need to provide care, so be sure they are included in this discussion. Obviously, everyone’s decision is personal. If you expect to care for a loved one through this last stage of life, please ask him or her now.

Evaluate nursing homes and assisted living centers. And make sure and look at the fine print. You may want to compare nursing homes online at the federal government’s website (www.medicare.gov/nursinghomecompare). The site allows you to compare ratings and locations among thousands of nursing homes. It’s surprisingly useful and includes a lot of information to help you decide if this might be an option for you.

Understand how you’ll pay for care. For instance, once you or your family member is in a nursing home, who pays for a hospitalization? What will be your out-of-pocket expenses for each major decision? Do you have insurance coverage, or perhaps money set aside for this expense? If not, the cost of care could decimate both your retirement portfolio and your legacy. You should have a plan for your care before you’re in the midst of it and don’t have the ability to take your time and consider what is best for you.

Don’t forget your spiritual needs. Whatever your beliefs, make them known to your family and loved ones. Do you want your priest coming by? Will you be buried or cremated? Who would you like to speak at your funeral? These issues should be discussed, and ideally even planned for.

I realize the topic of one’s own death is uncomfortable, even if it’s still decades away. But you and your loved ones deserve the peace of mind that this discussion brings. With New Year’s in a few days, make it a priority to begin the dialogue and execute a plan to help give you that peace of mind, knowing you’ve prepared for the worst.

So as always – be vigilant and stay alert, because you deserve more!

Happy New Year!

Jeff Cutter, CPA/PFS is President of Cutter Financial Group, LLC, an SEC Registered Investment Advisor with offices in Falmouth, Duxbury, Mansfield & Southlake, TX. Jeff can be reached at jeff@cutterfinancialgroup.com.

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