Your clients rarely imagine themselves being unable to make important medical decisions for themselves. Yet it happens regularly. In fact, one way to introduce the topic is to tell your clients that a healthcare proxy comes into play at times we don’t think about—when someone is in the recovery room after a routine surgery or is unconscious after an accident—as well as the times we all think about, such as when a person is slipping into dementia.
Because young and healthy people also may need a healthcare proxy without warning, it is crucial for all of your clients to have one in place. Without the proper planning, the most important health decisions could end up in the hands of estranged family members, doctors or even judges. How much better to have someone your client knows and trusts! Ensure that all of your clients, young and old, healthy and sick, have a healthcare power of attorney completed.
A Durable Power of Attorney for Healthcare may also be called a healthcare agent, healthcare attorney-in-fact or a healthcare proxy. It names the person appointed by your clients to make treatment decisions on their behalf. That power comes into play any time clients cannot make decisions on their own, either temporarily or permanently.
There are three imperatives:
- Clients need to choose an appointee and at least one alternate. Many times spouses appoint each other, but what happens if they are in a car accident together? Having an alternate assures continuity of care by a trusted person.
- The appointment of the proxy and the client’s wishes for treatment need to be reviewed at least annually. The choice of appointees may be affected by divorce, death or estrangement in the family, and treatment wishes may change over time, often depending on their state of health. Even if only to confirm the present arrangements, regular review is essential.
- The appointees need to know what your clients want and especially why they want it. No one can offer instructions for every possible scenario that may occur, but if proxies know the reasoning behind the decisions, they are equipped to interpret and carry out the spirit of those wishes regardless of the circumstances.
In order to accomplish this, clients need to have a living will, which is a type of advance directive that lists the treatments they do and do not wish to have in different circumstances. There are many forms available, from the standard form approved in each state to national forms like the Five Wishes document.
After completing the living will, clients must then have an in-depth conversation with the appointee to explain what they wish, including why they do or do not want certain treatments, what “quality of life” means to them, and the overall result they wish to achieve. A beneficial frame, for instance, is to have the client explain to the proxy what they need to be able to do, see, experience, understand or communicate in order to make it worth it to have artificial interventions to prolong their body’s life, and at what point (if any) those interventions are no longer wanted.
This is such an important discussion that you may wish to go the extra step of facilitating it. Bring your client and their appointees into the office or set up a video chat, so they can go through the living will and discuss it. This is an extremely valuable service for your clients, and at the same time it positions you to meet the appointees, who are often trusted members of the next generation, in a setting that exemplifies your care and protection for your clients.
When you ensure your clients have a living will and a healthcare proxy, they know you are protecting them in both financial and nonfinancial ways, you care about their lives, and you are serving their best interests. It also often connects you to the next generation in positive ways. It takes time, but it is an investment in time, not a waste. What have you got to lose?
Next month, I will explore options for clients who do not have someone they trust to serve as their healthcare agent.
Amy Florian is the CEO of Corgenius, combining neuroscience and psychology to train financial professions in how to build strong relationships with clients through all the losses and transitions of life.
