A living will – called an advance directive for health care here in California – is an important part of your estate-planning arsenal. In the event of an accident or life-threatening incapacitation, an advance directive dictates your medical care and treatment preferences. This is especially helpful to family members and care providers because where there is uncertainty and disagreement, the court may have to step in.

An advance directive for heath care can fail its essential purpose, though, if it is ambiguous about treatment options and does not provide enough detailed guidance.

A recent MSNBC article highlighted this problem in the story of Bunny Olenick, an 87-year-old from Boston who became incapacitated by a severe stroke. She had a living will and a medical power of attorney, but her sons were left with questions about assisted breathing devices and feeding tubes and the quality of life she would sustain because of them.

She had stated that she didn’t want to be intubated or hooked up to a respirator, but did that preclude temporary nasogastric tubes for nutrition or a short-term oxygen mask?

Bunny’s sons were able to take advantage of palliative care counseling, which helped them navigate her legal documents and the preferences she had shared with them prior to her stroke.

However, had the sons gotten into a disagreement about Bunny’s wishes, they might have ended up petitioning a judge to appoint a medical proxy. The legal process is costly and ultimately may prolong an incapacitated individual’s life or suffering where he or she would not want it.

No one really likes to ponder their own death, but appropriate advanced planning can save you and your family pain and confusion in a time better spent saying goodbye.

James D. Perry

A recent article by Forbes highlighted what I believe to be a serious problem: half of Americans don’t have even the most basic estate planning documents.

According to a phone survey conducted among 1,022 adults in December 2009, only 35% have a will and only 29% have a living will, which states an individual’s views on end of life medical procedures.

The numbers are only a little more promising for the elderly. Fifty-one percent of adults over the age of 65 have a health care power of attorney in place, and 58% say they have a living will.

The poor economy seems to have taken its toll – 44% report they are more focused on immediate needs, such as groceries and paying bills rather than future protection. And, there seems to be a misconception amongst the survey respondents that they don’t need an estate plan if they are not independently wealthy.

In fact, it can be more costly in the long run for those who fail to prepare estate-planning documents.

If you die intestate (without a will) a lot of your assets may get chewed up in probate court rather than going to your loved ones. And, your family may have to pay heavy court costs out-of-pocket if they have to go through legal proceedings to get a judge to appoint someone to make medical decisions for you should you suffer an incapacitating accident or illness.

If you haven’t put together an estate plan, I encourage you to do so to protect your assets, your personal wishes, and your family in the event they have to make difficult decisions.

James D. Perry