The COVID-19 pandemic brings us face-to-face with our mortality. Especially in hard-hit areas, it is painfully evident that everyone is at risk with this unpredictable infection, even young healthy people. Because of this, every one of your clients needs to complete or update their advance directives, including living wills and health care powers of attorney, clearly stating their wishes for the type of treatment they want if they become infected.
First, explain to clients that these documents only take effect if they are unable to make their own decisions. Completing them accomplishes two things: It helps the client maintain as much control as possible over their own medical care, and it relieves their family of the burden of having to make medical decisions without knowing what the client wants.
Here are exceptionally helpful resources to help clients gain the information they need to understand their choices and make wise decisions.
The Conversation Project is awash with videos, tips, and helpful information, including a downloadable PDF with COVID-specific information. It also provides “starter kits” for guiding families to have conversations about their medical treatment wishes, regardless of COVID-19. You can find a similar COVID-specific sheet of information along with tips on packing a hospital bag at Prepare for Your Care.
The National Hospice and Palliative Care Organization published a new tool that factors in age, other medical conditions and current symptoms to determine a person’s likelihood of survival should they contract the virus, along with education on what it means to be put on a ventilator and what life post-ventilator is likely to be like. This can help older clients with a serious underlying illness in particular to decide whether to go to the hospital if they have a critical COVID-19 infection, or stay at home with the support of hospice or palliative care services.
Make these resources available to your clients. Then ensure they write the treatments they do or do not want in a living will form. They can use the standard form for their state, or an alternate form such as the Five Wishes document, which is more comprehensive, prompts family discussions and includes not just medical wishes but also things like “comfort wishes.” Five Wishes is valid in every state when the guidelines are followed.
Another form, which clients can complete with their doctor, is the POLST paradigm form. It includes whether the client wants to have CPR and intubation based on their condition at the time, and when they wish to have palliative care and hospice services. With the doctor’s signature, it becomes a doctor’s standing order and can be entered into the permanent medical record.
Even more importantly, ensure clients appoint a power of attorney for health care, also known as a health care proxy – the person they choose to make medical decisions for them if they become incapable of making those decisions themselves. Clients should designate a single person to avoid having arguments, and at least one alternate in case the first choice is unable or unwilling to serve.
Finally, take one last crucial step and make sure your clients actually discuss their wishes with the persons they appoint, explaining what they want and why. When appointees thoroughly understand the client’s reasoning and quality-of-life desires, it eliminates guilt, second-guessing or regrets when choices are made.
Set yourself apart. Provide this invaluable education. Then follow through and help clients retain the greatest possible level of control, even in cases of serious COVID-19 infection.
While you’re at it, make sure you do all of this for yourself too!
Amy Florian is CEO of a firm that works with financial professionals and others who help the grieving.