Mapping Your Future

Peggy, a 59-year-old loan manager, was just picking up her life after a bitter divorce. Distracted while driving to work one day, she had an accident that left her in a coma. After a month of keeping her on life support, Peggy’s doctor delivered the news no family wants to hear: She was unlikely to wake up.

Her loved ones had to make decisions for her, but Peggy hadn’t left advance directives: legal documents that expressed her final wishes. If grief and confusion weren’t enough for her family to bear, the arguments that followed the doctor’s prognosis nearly tore them apart. But through all the pain and chaos, Peggy’s younger sister, Joanne, was quickly learning a valuable lesson: Making those “just-in-case” decisions before tragedy strikes can spare everyone additional heartache.

After the family came to terms with Peggy’s condition and made the painful decision to let her go, Joanne took the lead in charting her own road map for her loved ones to follow in the event she couldn’t communicate her wishes. As a single boomer-generation woman, she felt a particular need to take control of her destiny. To put her desires in writing, she needed to complete three important documents: a living will, a health care power of attorney, and a letter of instruction.

Why Create a Road Map?

Developing a road map keeps you in charge when it comes to decisions about medical treatment—even when you’re no longer capable of making those decisions. This kind of planning also shows compassion for family and friends. When loved ones are left guessing, too often the result is guilt, uncertainty, and arguing. By making your wishes known, you can help your loved ones feel more comfortable with the course of your care.

When women complete their own advance directives, they have an opening to talk with their parents about whether they’ve made choices about their future medical care. Parents’ decisions about their own care usually, at some point, involve their children. Starting the conversation and learning what care they want can give the whole family peace of mind. And it’s equally important for boomer women to share their advance directives with the young adults in their lives who are starting out on their own. 

What Do You Need?

Each of the documents women need for their road map serves a different purpose. The first two are legal instructions known as advance directives:

•    A living will tells medical professionals and your family which medical treatments you want to receive or refuse—and under what conditions. It only goes into effect if you meet specific medical criteria and are unable to make decisions.

•    A health-care power of attorney allows a woman to appoint someone to make health-care decisions for her any time she’s unable to do so. Most people choose trusted family members or friends who are comfortable talking to doctors. The power of attorney can also be referred to as a “health-care proxy,” an “appointment of a health-care agent,” or a “durable power of attorney for health care.” It is different than a regular durable power of attorney, which only covers financial matters.

The third part of the road map, a letter of instruction, isn’t a legal document, but it helps families find important information, saving them from having to dig through papers during a crisis. This document is a three-part personal letter that goes with the will. The first part includes instructions for planning a funeral and the names of people to contact. The second part covers financial affairs, such as lists of accounts and phone numbers for your employer, insurance agent, or broker. In the final part, people often give away meaningful possessions and write special messages to family members.

Taken together, the advance directive and letter of instruction give your family a road map for your wishes.

Getting Started?

Women first should consult an attorney for advice on the best way to tailor advance directives to their specific wishes. But they can find the components of their personal road maps without ever leaving home. Even though advance directives are legal documents, it’s not necessary for a lawyer to write them. If you would like to prepare your own, you can find forms specific to the state in which you reside at Caring Connections.

Five Wishes, offered by Aging with Dignity, is a good model for advance directives. It’s considered a legal advance directive in 40 states, and people in other states often use it as a starting point.

Since the letter of instruction is not a legal document, its contents are entirely up to you. If you need some help, AARP has suggestions for what to include in each section. On AARP.org, you’ll also find a worksheet to help you organize the documents your loved ones may need in an emergency.

Seeking Guidance

An advantage of having your attorney draw up the documents is that you then automatically have someone to review them—now and in the future—with an eye to keeping them current if there are changes in regulations. Lawyers often charge fixed rates for preparing documents, so it should be fairly easy to find an affordable lawyer. The American Bar Association maintains a list of free and low-cost legal services in each state.

You may also want to consult your health-care provider or another trusted source if you have questions about life-sustaining treatments or other medical terms found in the documents.  

What’s Next? 

•    Let family members know your wishes. Although it may be difficult or awkward to start the conversation, sharing your concern for your loved ones and communicating your beliefs and values can help set the right tone for the dialogue.

•    Keep a copy of your road map in a safe accessible place. Tell family members where to find it should an emergency arise.

•    Go over the road map with your designated health-care agent (named in your health-care power of attorney) and your back-up agent. Discuss any concerns, and make sure they have copies of all your documents.

•    Discuss advance directives with your doctor, and have a copy of them placed in your medical record. If your doctor seems uncomfortable following your wishes, consider changing health-care providers.

•    Review your road map every few years. These are tough decisions, and your views may shift as your health or circumstances change.

Planning for the unknown is never easy, but it’s a gift to your loved ones. By having a road map, you can make sure you’re comfortable no matter what direction your journey takes. 

This article is part of a new AARP campaign to educate women about long-term care planning. AARP advocates nationally and at the state level to improve access to affordable long-term care options.