Living Well More than half of us are playing "chicken" with time...
That's due to procrastinating on end-of-life planning and not having "the talk" with loved ones about how we want to die.
You don't have to be old or in ill health to start planning and relaying your plans to loved ones.
Don't forget – life is full of accidents. Even if you're young and healthy, a serious accident might be waiting in the wings. It could result in you becoming incapacitated (or worse, dying).
And if you don't have your plans squared away on how you want to be treated during your finals days or after you die, you risk leaving your body's care in the hands of perhaps an estranged relative. Or worse, the government could decide for you. You also may risk leaving your grieving partner or loved ones with the burden of having to make major medical decisions on your behalf.
In November, digital end-of-life-planning platform Afterall conducted a survey and found that 90% of Americans understand how crucial it is to have that talk. But more than 50% of folks haven't had the conversation.56% of folks haven't done it yet.
If you're among that group and have no clue how to get started, don't worry... we've got you.
Just like dipping your toes in to test the water, you might find it easier to do this...
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Instead of jumping straightaway to thinking about death, maybe start by thinking about what matters most to you in life.
And maybe don't just list things in your head... Try putting it all on paper. Research has shown expressive writing helps lower anxiety and stress in most people. So grab a piece of paper and a pen. Personally, I'm a big fan of journaling. I find that giving my deepest thoughts and emotions a physical form helps validate my feelings surrounding them.
Next, go through my list of six key questions to ask yourself about how you want to spend your last days. You can also use this list to open up a conversation about end-of-life planning for your loved ones, too, if they don't know where to begin...
Six End-of-Life Questions to Ask Yourself
1. Have you made a living will?
This document spells out what your wishes are regarding ventilators, heart shocks, and other interventions if you're sick. It's hard to know now, but imagine if you had dementia and didn't know your spouse's name or couldn't even feed yourself. Would you want extraordinary measures done to keep you alive? Would you want to be treated for pneumonia or just allowed to die?
If you want to make sure that you maintain control of your medical care to the very end, you need to make it official. I talked about living wills in a recent Retirement Millionaire issue. Not a subscriber? Check it out for a month, risk free.
2. Have you chosen a health care proxy?
This is the person you chose to make decisions for you if you're incapacitated. Talk about it. I've known families where two kids thought their dad wanted everything done to keep him alive, and two siblings thought the exact opposite. You can't have it both ways. Someone will make the decision, and relationships can fracture over it.
Sit down with your designees and make your wishes clear. I recommend doing it with at least two family members and have them write out your wishes so you're sure they understand.
3. Have you thought about where you want to spend the last days of your life?
At home? The nursing home? Don't forget about "hospice care," which doesn't provide treatments, tests, or interventions in your last months of life. It's more about making sure your final days are comfortable and pain free. I'd like to go at home with little pain. But everyone's decision is personal. If you expect to care for a loved one through this last stage of life, please ask him or her now.
4. Have you considered nursing homes and assisted-living centers?
Be sure to look at the fine print.
When my stepmother and I were moving my dad – who suffered from dementia – into an assisted-living home, no one explained the "sit and pivot" rule to us. (To stay at the assisted-living home, my dad had to be able to sit up in bed on his own and pivot his feet to the floor to get in and out of a wheelchair.) We thought a place with a dementia center would naturally be prepared for someone like him. As a result, we kept him home too long to qualify – due to the sit-and-pivot rule – for the sort of care an assisted-living center offers. It's rough to find out on the day you bring your loved one for admission.
And be sure to look at the federal government's website on nursing homes. The site allows you to compare ratings and locations among thousands of nursing homes. For a U.S. government site, it's surprisingly useful and full of information to help you decide what's best for your situation.
5. Have you figured out what's covered by insurance when someone is dying?
Once you or your family member is in a nursing home, who pays for a hospitalization? What will be your out-of-pocket expenses for each major decision?
For example, if you had $250,000 to leave to your daughter, but you were in your last year of life, would you want to be treated out of pocket or forgo it and let your child get the money? It doesn't seem like a big deal now... But you and your daughter should talk about it. Imagine if you discovered she felt the exact opposite... You should know these things before you're in the midst of it and don't have any control to take your time and consider what is best for you.
6. Have you addressed your spirituality?
Whatever your beliefs, make them known to your family and loved ones. Do you want your priest coming by? Do you want music?
These issues should be discussed, if not explicitly planned for.
Finally, once you've completed your end-of-life planning, I suggest you top things off with a "goodbye" letter to your loved ones.
Stanford University has a Seven Vital Tasks of Life Review form that you can download and print for free. Researchers found that most patients who did this life review were "able to achieve a measure of peace that comes from deep reflection about key life experiences, and the important relationships they have cultivated." The seven tasks include topics like forgiveness, remembering key life experiences, thanking and acknowledging people in your life, saying "I love you" to folks, and, of course, saying "goodbye."
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Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
March 20, 2025