When Tom Petty was found in cardiac arrest earlier this month, his family reportedly took him off life support, citing a do-not-resuscitate order the rocker had established.
Making arrangements for your care should something happen to you should be a crucial part of your estate plan. And the considerations extend beyond your health.
Spending for out-of-pocket medical expenditures in the last year of life averages $11,618, according to 2010 research from the National Bureau of Economic Research.
Those costs would probably be closer to $18,000 today, taking health-care inflation into account, estimates Carolyn McClanahan, a physician and director of financial planning at Life Planning Partners. And for families with more liquid assets, that tally is usually higher, she said.
The magic number when individuals should make arrangements for their care: 18 years old, according to McClanahan, who is a certified financial planner. Yet just 26.3 percent of adults have an advance directive, a legal document that stipulates your wishes if you are debilitated or unable to speak for yourself, according to 2013 data from the National Institutes of Health.
"If you have something bad happen, if you don't have these forms in place, there's nobody there to make decisions for you," McClanahan said.
A do-not-resuscitate order is a form signed by a doctor used in the event an individual suffers from a serious advanced illness. The form instructs health-care professionals not to perform CPR. Individuals may also want to consider a do not intubate order, which instructs medical personnel not to insert a tube into the body.
"It's unusual for someone who is healthy to have a DNR form at home," McClanahan said. Petty could have established the form because of a known health condition or out of general concern. "He set his own rules. He lived hard, too. You never know," McClanahan said.
Both DNR and DNI forms can serve as parts of an advance directive, which is signed by an attorney and takes effect in the event that you cannot speak for yourself. That includes a chronic end-stage disease, terminal illness or persistent vegetative state, according to McClanahan.
"You have some massive thing happen to you and it leaves you being a person you don't want to be," McClanahan said. "That's the No. 1 reason you need advance directives."
One kind of advance directive is a living will, which stipulates the kind of medical care you want to receive. That includes treatment such as tube feeding, dialysis and pain management.
One of the most important parts of putting this kind of plan in place is to communicate with your health-care surrogate, or the person whom you have designated to make decisions for you, McClanahan said. That includes sharing what you would want to happen if you lost the ability to communicate or process bodily functions such as chewing and swallowing, bathing or toileting needs.
"When your health-care surrogate has a measure of what's important to you, it can help them make better decisions for you," McClanahan said.
Individuals also want to make sure they have a durable power of attorney, a legal document that gives someone the power to make decisions regarding your property such as houses, brokerage accounts or individual retirement accounts, said Tom West, partner at Signature Estate & Investment Advisors. In contrast to a general power of attorney, a durable power of attorney provides for the event the individual becomes incapacitated, West said.
Ideally, the same person is in charge of both medical and financial decisions to prevent conflicts. West cites a real-life example where an adult daughter recommended an expensive living facility and additional 24-hour care for a parent suffering from dementia. The adult son handling the finances, however, did not want to pay for what he considered to be too much supervision.
If proper provisions are not made in advance, conflicts can play out publicly in court, West warned.
Getting the paperwork done right often means working with an attorney, rather than just filling out an online form.
"Have a seasoned guide that has been through the chapters of the stories with a lot of other families," West said. "It's worth a few hundred bucks to actually get some feedback and advice as opposed to doing it yourself."