A July 2010 survey by Thomson Reuters found that 57 percent of Americans have made their end-of-life care choices known. This is significantly more than in previous surveys. As you might expect, more people over the age of 65 have taken this step. In fact, nearly three-quarters of people over 65 have done so, as opposed to about a third of individuals under the age of 35. Among those who conveyed their end-of-life preferences, 87 percent chose informal communication with family, friends, or loved ones; 60 percent created a living will; and 50 percent employed a healthcare power of attorney. Typically, those who took formal steps received legal assistance in preparing their documents.
What conclusions can we draw from these numbers? On the one hand, it is reassuring to know that more than half of the Americans surveyed understand the importance of thinking about their preferences for care at the end of their lives and have chosen to express them. The efforts of estate planning attorneys, the National Healthcare Decisions Day initiative, and other educational programs to generate awareness about this important issue seem to be paying off.
Of course, another view is that there is still plenty of work to be done. Roughly 40 percent of Americans surveyed still have not expressed their end-of-life care choices. It is also important to note that while 87 percent of the respondents who made their wishes known did so informally, significantly fewer Americans utilized a living will, healthcare power of attorney, or other written directive. Clearly, opportunities exist for estate planning and elder law attorneys to provide individuals who are already aware of the importance of expressing end-of-life care choices with the formal legal documents they need to help ensure that their wishes are indeed carried out.
Finally, clients need to remember that making one’s wishes known, even through formal means, is no guarantee that they will be available to hospitals and loved ones when they are needed — especially in an emergency. Enrollment in a healthcare directive registry can be a good way to provide that assurance for clients.
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 175,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. Randi is an ongoing contributor to the Academy blog.
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