When a systemic problem never sees the light of day there can be no impetus toward solving it, and one of these challenges that exists in the realm of elder law involves the way that we approach the end of our lives. 75% of people die in medical centers, hospitals, or nursing homes. We all know that the costs of hospital care are high, but some 20% of people actually die in the intensive care units of hospitals at a cost that can reach as high as $10,000 a day. Remember, we are talking about people who are in the ICU because they are going to die without any chance of recovery.
In 2008 Medicare paid out $50 billion to health care providers who were treating people during the last two months of their lives. To put that into perspective this amount exceeded the budgets of Department of Homeland Security and the Department of Education. This is Medicare, but how much did private insurers pay, how much did Medicaid pay, and how much came out of the estates of the individuals who passed away? Once again, all of this money was spent for naught because the people were dying as it was being spent. Plus, dying with tubes and machines keeping you alive as long as possible is uncomfortable, and it can be argued that it is not a very dignified way to pass on.
Most people don't want to be kept alive through aggressive and intrusive medical procedures when they are in a terminal condition, and you can state your wishes in this regard by executing a living will and/or a durable medical power of attorney. With a living will you state your preferences regarding the treatments and procedures you are willing endure, and with the durable medical power of attorney you appoint someone to make medical decisions on your behalf should you become unable to make them for yourself. If you care about your legacy enough to engage in estate planning, it is important to address these end-of-life issues as well and take personal control of your own final days.
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