Planning for end of life

In life, we all experience serious injury or illness. At some point, all of us will face our mortality. When the time comes, you want to be sure you and your family members are prepared.

All adults, regardless of age, can prepare for these decisions and have the documents in place that allow others to know and act on our decisions under these circumstances. Many people do this as soon as they retire, but some people may not begin planning until they have an accident or are in poor health. It’s best to begin before there is the additional stress of failing health.

Research tells us that people like to put off signing advance directives or engaging in advance planning, even though common sense says there’s no time like the present. It’s very human to not want to think about the end of your life and what you might do about your healthcare and finances. But the only way to be certain you receive the best legal help and your final wishes are met is to get everything in order sooner rather than later. Whether it’s been at the back of your mind or it’s starting to feel urgent, there is help to plan for the future.

Legal help for advance directive planning in Georgia

First, be sure you have all the resources you need within reach. If you need legal assistance during your advance planning, there are many options if you don’t have a lawyer readily available. Older adults in Georgia can access free legal advice, brief service, or referrals by contacting the Georgia Senior Legal Hotline. This is a free telephone service staffed by attorneys who take calls from older Georgians and their families. If you need to find a lawyer with experience in elder or special needs law, check out the National Academy of Elder Law Attorneys. For more help finding a lawyer in Georgia, you can use the tools on the Georgia State Bar site.

How to start planning

Getting things in order may take some time—it depends on how many conversations you need to have, whether you are familiar with the paperwork, whether your assets are complicated, and whether you already have access to legal counsel. However, before you dive into the legalese, you want to start by having conversations with your family and trusted loved ones to make sure they understand your wishes.

How to talk to your family about your wishes

If you aren’t sure how to get everyone together and how to convey how you feel, the Conversation Project has helpful resources to help you get started.

If you are trying to decide who to nominate to make your healthcare decisions, be sure to choose someone you trust—a person who will honor your wishes and your values. You may also want to nominate a successor or secondary decision maker so you can feel safe knowing you have more than one person to rely on.

While making your decisions, be sure to consider your unique family dynamics and the legal position in which each person may find themselves. You can decide who you want to make decisions if you aren’t able.

If you haven’t appointed anyone to make decisions on your behalf, and you are unable to consent, Georgia laws authorize your family to make your healthcare decisions.  While a surviving spouse is the primary person for physicians to consult in a medical situation, if a spouse is not available, the doctor will next ask your adult children—who will each have an equal say. Even in the closest of families, there can be different opinions about what Mom or Dad would or wouldn’t want regarding healthcare decisions. Be sure to clearly communicate what your intentions are, then formalize your decisions—about what you want and who you want to make decisions—by filling out the paperwork for your advance directives.

Understand typical end-of-life decisions

While advance directives apply to all types of healthcare decisions at any time in your life, it’s also important to understand the types of medical decisions you may have to make near the end of your life. If you are very sick and you only have a short time to live, you will have to decide on the type of care you would like to receive. You typically have these choices:

TreatmentIn the absence of an advance directive or if you choose full treatment in your advance directive, medical personnel will general continue all available and reasonable medical treatments to attempt to cure or treat your serious illness.

Do Not Resuscitate OrderDNR is an medical order meaning that if your heart stops beating or if you stop breathing, healthcare providers will take no life-saving measures.

Palliative carePalliative care is comprehensive treatment of the discomfort, symptoms, and stress of serious illness. It does not replace your primary treatment; palliative care works together with the primary treatment you’re receiving. The goal is to prevent and ease suffering and improve your quality of life.

Hospice care—Hospice care is focused on quality of life rather than length of life. If a doctor determines that you likely have less than 6 months to live you can typically qualify for hospice under most health insurance plans. Making sure you have no pain or other distressing symptoms are key to hospice care. The service also provides support for family members during this time.

For more information on the decisions you may have to make, download this slip sheet from Sixty Plus, a division of Piedmont Hospital.

Planning for your medical wishes

Advance directives in Georgia

Now you are ready to start filling out forms. Georgia provides a way to express your health care wishes due to injury or illness in advance. The “Georgia Advance Directive for Health Care” takes you step by step through the process of making health care decisions in advance and naming who you trust to make those decisions for you in the event you are unable to. This person may state your treatment preferences if you have a terminal condition or if you are in a state of permanent unconsciousness. You may have heard someone refer to a living will or a durable power of attorney for health care—this Georgia form combines both of these documents into one. Be sure to read through this document carefully. It may look long and complicated at first glance, but it is really very simple.

The important thing to know is that whenever you sign this document, you want to sign it in front of two witnesses who are not related to you and would not benefit in the event of your death (meaning no one mentioned in your last will and testament). You do not need to go through a lawyer to complete this document, and it doesn’t even need to be notarized.

Once you complete this form, you will want to make several copies. Be sure to give one to the person or persons you nominate and one to your healthcare provider. Some people keep a copy in their cabinet or car. You never want to keep this form in a lockbox or safe. This form needs to be accessible in the event of an emergency. You may want to note the location of your advance directive form in your Personal Health Record, so that it can be found easily, regardless of the situation.

It’s also important that you routinely review and update your Advance Directive to make sure that your stated wishes are still accurate. It’s not unusual for a husband and wife to name one another as each other’s agents, but then what happens if one of them develops memory loss? That person may no longer be appropriate for the doctor to go to for healthcare decisions. It is simple to change these forms: simply complete a new one and ensure that you give the updated copies to every relevant person.

How is an advance directive different than guardianship?

Guardianship is when a court appoints someone to make decisions for another (it is sometimes called conservatorship in regards to property decisions). Since the rights of the adult are limited under guardianship, it is typically considered a last resort. Athens-Clarke County offers more information on Adult Guardianship and alternatives in Georgia. If there is no one who is “willing or suitable” to provide guardianship, the Public Guardianship Office (PGO) will be appointed as a last resort.

Planning for your financial wishes

Financial Power of Attorney in Georgia

You can name someone you trust to make decisions about money and other property by completing a Financial Power of Attorney. It is wise to consult legal advice regarding this form. Be sure that the person you are nominating fully understands their responsibility. You will need to file a copy with every relevant organization, such as your banks or your credit union. Some banks and financial institutions utilize the standard state form, while others have their own version. If you need to fill out more than one version of this form, be sure that all the information is consistent across each edition.

Completing your will in Georgia

In addition to decisions related to your health, you probably have wishes related to what happens to your property after your death. Those decisions can be set forth in a will (also known as a “Last Will and Testament”). The Georgia Department of Human Services has a helpful guide or a lawyer can answer your questions about wills.

It is important to note that your will can be pre-filed. This means that once the document is complete, it can be filed before your death in your county’s probate court. This way, in the event that you pass away unexpectedly, your loved ones won’t have to search for the document, guess a combination, or search for a lockbox key.

Additional resources

Personal information and preferences worksheet

Record information about yourself and your preferences in case you need long-term care in the future. The information you provide on this worksheet will help family and caregivers to understand you better and provide better care.

Final arrangement details
For more assistance making your final arrangements, download this resource from Georgia Division of Aging Services.

An advance planning toolkit
You can also access this Toolkit for Advanced Planning from the Commission on Law and Aging.

Need more help planning for your future healthcare or financial decisions?

Having signed legal documents is not the goal of advance planning. The goal is to clearly communicate your values so that family, friends, and healthcare personnel can fulfill your wishes at times when we aren’t able to speak for yourself. If you need help following the steps outlined here, empowerline can connect you to additional resources.

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