In our lifetime, we have seen incredible advances in medical science. Think back 30 years. In 1982, a heart bypass operation was a really big deal. It meant weeks in the hospital and very risky surgery. Today, surgeons barely have to cut us open to reach into our bodies with instruments that enable them to do multiple bypass surgeries and have us out of the hospital in a matter of days. As a result of these kinds of advances, people in this country are living longer and longer. What we are finding, however, is that longer life does not necessarily mean improved quality of life.

For a growing number of us, the chances of needing nursing home or other kinds of long term care are increasing. The average person in 2012 stands a 66% chance of being completely incapacitated for some period of time (which may or may not include a stay in a nursing home), and 25% of us will require long-term care. Planning for this eventuality is something we should all make a high priority.

Figuring out how to finance long term care and choosing the right retirement community or nursing home involves an important set of issues that you should discuss with your financial planner, your insurance professional, and your other trusted advisors. A different, but related, set of issues arise in the legal arena.

If you have not done this already, do not wait another day before you contact your attorney or find someone who can advise you about planning for the possibility of incapacity. The concerns break down into two categories: dealing with your person (making decisions about your medical care, your living situation, and when — if ever—to stop medical intervention), and dealing with your stuff (taking care of everything you own if you lose the ability to do it yourself).

Both of these categories involve choosing and then legally empowering your hand-picked decision makers. Taking care of you and taking care of your stuff involve different issues, so think about whether to have the same people in charge of both. You may want one set of people or institutions to be your caretakers, and another set to be your trustees.

At a bare minimum, you will probably want to have an Advance Health-Care Directive (AHCD), an authorization to your medical personnel to share your health information with your Health-Care Agents, and a Durable Power of Attorney (DPA). Depending on the complexity of your estate and your family situation, you may want to have other things in your estate planning toolkit, such as a will and a revocable living trust agreement.

It is critical for you to learn your options and what kind of instructions you can give your loved ones in the event that you cannot speak for yourself. There are many good books, websites, and workshops available.

Scott Makuakane, Attorney at Law
Specializing in estate planning and trust law.
O‘ahu: 808-587-8227, Maui: 808-891-8881