A Roadmap to Better Health Care
By Lynn A. Ferraina | èBella Magazine | December 2018
Your financial plan serves as the cornerstone of your retirement, providing you with the foundation you need to enjoy your desired retirement lifestyle. That being said, an effective financial plan goes beyond the management of your assets and investments.
Health care is an issue that impacts everyone in a deeply personal way, especially as we enter the golden years of retirement.
Given the steadily rising costs of services and the ever-growing complexity of health care decision-making, the need to weigh legal and medical considerations has never been more critical for promoting your continued financial success.
I interviewed Jill Ciccarelli Rapps, a financial advisor at Ciccarelli Advisory Services, Inc.; Dr. Susan Cassidy, a physician and attorney who owns CriticalMD; and Marve Ann Alaimo, an estate planning attorney at Porter Wright to discuss how you can prepare for the inevitable medical decisions that lie in your future.
Q: What are the most common mistakes you see when evaluating a client’s health care plan?
Jill – Failing to communicate your wishes seems to be a common pitfall – not just the what, but also the why and how. You have to start the conversation early with the health care surrogates you have chosen to discuss these uncomfortable issues in a meaningful way.
Marve Ann – A common mistake I see is assuming that a living will and health care surrogate form are nothing more than boilerplate forms. But these documents are essential; they are more than just add-ons to a will or trust. The living will and health care surrogate documents require careful consideration.
Susan – It’s imperative to remember that, just like estate planning or financial planning are necessary, medical planning is equally important. You need your specific wishes and values to be in writing and official – all the way down to the specialized situations or complications you might face.
Q: Which legal documents will I need to ensure that I remain in control of my health care plan?
Marve Ann – The basic foundation would be a will and your health care documents – the living will and health care surrogate form. Within these documents, you need to address quality-of-life issues as they relate to your medical care. All of your other priorities also need to be documented formally.
Susan – On top of that foundation, I use a tool called a medical roadmap for care. The roadmap lays out your values and preferences, highlights major life transitions, and outlines how to make decisions about which medical interventions fit those values and preferences.
Q: What’s the best approach for talking to my family about my health care wishes?
Marve Ann – Ideally, you should gather all involved parties together for an in-person family meeting. Start by explaining the reasoning for your health care plan. One key reason is to prepare yourself to live a dignified life during the months or even years between incapacitation and death. Then, discuss who you have appointed as your surrogates (and why) and how that person should make decisions and communicate on your behalf.
Jill – We have had great success when a third-party moderator drives the health care discussion with the whole family. Select a facilitator who is independent and experienced. That person will often bring up questions that the family never even considered before. Of course, this health care discussion isn’t a one-time deal, either. The key for effective family communication is having these open conversations on a regular basis.
Q: What is the single most critical piece of health care planning advice you could provide for someone who is approaching retirement?
Jill – A well-thought-out health care plan is an integral part of an effective financial plan. Find an experienced advocate who can guide your family through your health care plan and handle the regular updates and maintenance of your plan. Working with your family dynamics and personal circumstances is a huge part of building a successful health care plan. It’s also a great opportunity to start engaging your children and get them thinking about their own plan.
Marve Ann – As people build their savings during their lifetime, the legal and financial considerations they face get more complex and difficult to navigate. There is a serious need to recognize the complexity of medical considerations and to prepare the appropriate legal base of documents that address the details of your plan.
Susan – Communication alone is not enough for your health care plan. You must draft your plan! That means having official written documents that reflect the values that are important to you. Many doctors don’t have the training to read legal documents and may misinterpret your wishes if the living will is not laid out clearly. Without detailed, well-drafted documents, you could put yourself in a position where the care you receive actually induces more suffering.
