April 16th: National Healthcare Decisions Day (www.nationalhealthcaredecisionsday.org).

Putting aside the heated discussions and implications around healthcare reform…if you want to have some control over the way you are cared for, especially at the end of life, you should consider advanced care planning. Our laws allow us to put our wishes in writing through advance directives, and one of the most important pieces of that puzzle is appointing a healthcare surrogate (sometimes called Healthcare POA or proxy) to make decisions on our behalf if we are unable. Although there’s been some progress in the number of people completing advance directives, still only about 1/3 of elders have these documents.

And…even those who have completed the documents often neglect to talk to their family/healthcare surrogate and doctor about what they want. We find time and time again, individuals have gone down a path they would not have intended, or start to ask why they are completing certain tests and procedures. It can be hard to take a step back, especially in the middle of a crisis, and consider desires, goals/expected outcomes and options.

Reflect on these things as we approach National Healthcare Decisions Day and consider putting your wishes in writing if you have not already done so. Talk to your family, especially if you are facing a new diagnosis or chronic illness. Consider talking to a professional care manager (healthcare advocate) as you face decisions…whether for yourself or when acting as your loved one’s surrogate. See: https://www.agingwisely.com/advocacy/ for more info.

The American Bar Association offers a Proxy Quiz, which is an interesting exercise in what you would want, and what your proxy perceives you would want…great starting point for a discussion…

There was recently a NY Times blog post (http://economix.blogs.nytimes.com/2010/03/02/getting-old-is-expensive/) regarding a subject I have covered for many years in presentations regarding Medicare, Aging Wisely and planning ahead–the cost of healthcare in later years. Very few people think about this stuff ahead of time…why would you? We’re all busy dealing with our current health insurance, employment, etc. So, people generally know Medicare exists (and often seem to have the impression it will take care of everything with little/no cost) but rarely understand all of it’s working parts, costs, etc.

As this article quotes as recent study and has been shown in studies for a # of years, out of pocket/uncovered costs from 65 til death usually rank in the $250,000 range. Check out our Medicare 2010 Fact Sheet for some info. on the many premiums, copays and deductibles of the various parts of Medicare for the primary costs: https://www.agingwisely.com/2010-medicare-fact-sheet/. Still, as one person pointed out in response to the NY Times blog, when you consider similar costs for employer based insurance, this may not be such a bad deal or the horrific figure it is made out to be. I just worry that people don’t factor it in to their retirement planning or get much education about Medicare prior to the need. I always get a lot of great questions when doing my “Medicare 101” presentations or when we do a consultation with someone as they plan to retire…just wish more people would get that type of info. This should be an absolute part of anyone’s retirement planning process.