As retirement planning professionals, Rajiv Nagaich and his AgingOptions team are used to dealing with people procrastinating. One of the elements of planning that many people tend to put off is advance care planning – what will happen should you become unable to make medical decisions on your own, and who will decide for you how you will spend your last days. Let’s face it, planning for what will likely be the end of your life on earth is not a subject to enter into lightly.
Doctors Warn of the Necessity for Advance Care Planning
But now the shocking new reality of COVID-19 is forcing people to take this essential part of retirement planning seriously, and it’s not just the lawyers and planning professionals who are advocating end-of-life planning with newfound urgency. The nation’s physicians are sounding the alarm as well, as evidenced by this article just published on the JAMA Network. The publication called JAMA used to be widely known as the Journal of the American Medical Association, so when JAMA talks, people tend to listen.
The recent article, co-written by several doctors, contains a stark warning. “The novel coronavirus disease 2019 (COVID-19) pandemic is challenging health care systems worldwide and raising important ethical issues,” they write, “especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity.” The coronavirus has a dangerously high mortality rate for many patients, especially frail seniors, and doctors fear they will soon be forced to choose who gets care and who doesn’t as our medical system becomes dangerously overloaded.
Advance Care Planning: Does the Care You Get Match Your Values and Goals?
Moreover, the article goes on to add that, even if hospitals are not overcrowded, doctors need to know what patients and their families want. “Even if capacity to provide care is sufficient, one priority should be addressing goals of care in the setting of acute life-threatening illness, especially for patients with chronic, life-limiting disease. Clinicians should ensure patients receive the care they want, aligning the care that is delivered with patients’ values and goals.” The problem is obvious: if the doctors don’t know what the patient’s values and goals are, then care alignment is impossible.
The JAMA article says that the coronavirus has heightened the urgency of providing what the authors call “goal-concordant care.” That’s because the sickest coronavirus patients “will be older and have greater burden of chronic illness – exactly those who may wish to forgo prolonged life support and who may find their quality of life unacceptable after prolonged life support.” The authors add, “In this context, advance care planning prior to serious acute illness and discussions about goals of care at the onset of serious acute illness should be a high priority.”
Three Reasons Why Doctors Urge Advance Care Planning
The JAMA article states three reasons why advance care planning at this dangerous time of the coronavirus pandemic is so urgent.
- The Patient’s Wishes: This should always be top priority. “Clinicians should always strive to avoid intensive life-sustaining treatments when unwanted by patients,” says the article.
- The Hospital’s Capacity: Maxed-out hospitals should not waste resources providing unwanted care. “Avoiding nonbeneficial or unwanted high-intensity care becomes especially important in times of stress on health care capacity.”
- Protection of Others: Providing acute care unnecessarily puts others at risk, says “Provision of nonbeneficial or unwanted high-intensity care may put other patients, family members, and health care workers at higher risk of transmission of [coronavirus).”
The prescription from the JAMA article is crystal clear. “Now is the time to implement advance care planning to ensure patients do not receive care they would not want if they become too severely ill to make their own decisions,” the authors state. “As eloquently pointed out by an [intensive care physician], ‘If you do not talk with [your family] about this now, you may have to have a much more difficult conversation with me later.’”
There’s quite a lot more in the JAMA article and we encourage you to take a look. But the message is unmistakable. If you have never set your advance care directives down in clear fashion, or if your directives are out of date, now is the time to get that important planning step accomplished. Fortunately, through our partnership with LifePoint Law, we at AgingOptions have made it possible for you to do just that, in many cases without even having to leave your home during this time of sheltering in place.
Important Retirement-Planning Announcement from AgingOptions
At AgingOptions our chief desire is to help you prepare for the kind of retirement you’ve always dreamed of having. In cooperation with our partners at LifePoint Law, we are excited to launch a ground-breaking new service called the LifePoint Law Emergency Legal Kit. Without leaving your home, you can now consult with a LifePoint Law attorney who will work with you to prepare and sign a complete set of vitally important legal documents including both Financial and Healthcare Powers of Attorney, a Living Will/Advance Directive, a Will or Trust, and much more.
American Bar Association Website Cites LifePoint Law’s Innovative Approach
This pioneering approach to a challenging issue has caught the attention of the Washington State legal community. After the American Bar Association website published this article by Rajiv Nagaich explaining how the Emergency Legal Kit conforms to state law, another attorney published this ringing endorsement on the same ABA website. “Rajiv Nagaich’s excellent analysis on this issue, which makes the case that Washington State law can and should be interpreted to allow remote witnessing of estate planning documents, points to the need to bring the entire range of personal and estate planning documents into the digital age,” wrote Attorney Charles Sabatino. He praises Rajiv for “creatively [using] a state law option” that permits remote signing of important legal documents.
“In the face of our current public health crisis,” Sabatino continues, “the lack of remote digital execution and notarization options in personal planning has stifled personal legal planning options for countless Americans who are most at risk and need to ensure their wishes are known and their affairs are in order. The coronavirus outbreak has made advance planning more important than ever.”
Click on the link above for more about the Emergency Legal Kit, or call us at AgingOptions and we’ll explain this excellent service to you.
Also, if it’s time for you to get serious about all aspects of retirement planning, including finances, housing, health and family issues, Rajiv Nagaich has scheduled several of his popular, free LifePlanning Seminars in the form of webinars that you can watch conveniently at home. Simply visit our Events Page and register for the webinar of your choice.
Reliable information has never been more important – and that’s our promise to you at AgingOptions and LifePoint Law. Age on!
(originally reported at https://jamanetwork.com)