Comprehensive Advanced Directives

By Elyse Umlauf-Garneau

"Should, woulda, coulda." That's the refrain of so many caretakers who wondered if their loved ones spent their final days in the way they'd wished to.

Though it's certainly a challenging topic to raise, finding out what loved ones have in mind can make people's final days comfortable and reduce the gnawing regrets that children and caretakers so often face.

Was that the right environment? Did I play the right music? Should I have called in clergy? Should I have had a memorial service instead?

Five Wishes helps people address all questions.

It's an online or paper-based workbook that allows people, whether they're young and healthy or they're facing serious illness, to address end-of-life care and clearly outline their wishes.

It also removes the doubts for caregivers about whether or not to perform end-of-life heroics, and it can clear up some of the murkier issues, such as comfort and pain management and spiritual wishes.

The document addresses the key things all living wills do. That is, it allows people to identify who will make decisions on their behalf and the medical treatments they do and don't want. It also addresses their definition of life support (some consider it food, others consider it life-saving surgery) and allows people to spell out what they want done under a given set of circumstances.

But Five Wishes goes further and lets people share details of how they envision their final days.

Five Wishes is divided into five categories or wishes. They are:

• The person I want to make health care decisions for me when I can't
• The kind of medical treatment I want or don’t want
• How comfortable I want to be
• How I want people to treat me
• What I want my loved ones to know

It encourages people to think through and write down those details that caregivers find so troubling. To shed light on those subjects, Five Wishes offers up statements that people can check off, such as: 

• I want pictures of loved ones in the room/near the bed
• I want warm baths often
• I want to have my hand held, even if I don't seem to respond to voice/touch
• I want to have personal care, such as hair brushing, tooth brushing and nail clipping done
• I want religious readings and poems read aloud when I'm near death
• I want to be cared for with kindness and cheerfulness, not sadness.

It also provides space so people can specify how they want to be remembered, the memorial service they want, and a request that family and friends respect their wishes even if they disagree with them.

The layout and language of Five Wishes are accessible and free of the dense, impossible-to-understand fine print. It's available in 26 languages, including French, Urdu, Tagalog, and Hebrew, and it's legally binding in 42 states. However, before executing Five Wishes, it's wise to check with an attorney to be certain that it's legal in your state and also to find out how to revoke any previous living will that you've signed. 

For more information, visitwww.agingwithdignity.org.

Beyond Just Stashing Retirement Cash

Here's an alarming statistic.

One-in-four (25%) Baby Boomers (aged 46-64) have no retirement savings, and 22% of matures (aged 65 and over) are in the same position. That comes from a Harris Poll from earlier this year.

If you're among them, now is the time to take action and get up-to-date financial education, even if you're scared or if you're tired of hearing about retirement planning.

MetLife's "2011 MetLife Retirement Income IQ" study (www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-2011-retirement-income-iq.pdf)sheds further light on the need for better understanding of an array of retirement-related topics that go beyond just stashing away cash.

The study found continued misunderstanding about critical issues that affect retirement, including life expectancy, inflation, retirement income/savings, and long-term care insurance.

Maybe you're similarly foggy on certain concepts. The study's nitty-gritty numbers about what people know or don't know seem less relevant than the lessons you can take away and apply to your own situation.

Consider the following:

Longevity:With longer life spans facing retirees, financial strategies need to ensure that income will last throughout their retirement years.

Study findings: Almost one-third (32%) of respondents know that there is a 50% chance that they'll live longer than the expected 85 years. Yet many respondents believe that those chances are only 25%, and therefore underestimate the probability of living that long.

Underestimating retirement income needs:Middle income Americans in their mid 50s to early 60s are at risk of not having adequate income to cover basic expenses, such as food, clothes, transportation, housing, and basic health expenses during retirement. The rule of thumb is that you'll need 80 to 90 percent of your pre-retirement income to maintain a comparable lifestyle during retirement.

Study findings: Almost half (48%) underestimate the amount needed, a miscalculation which has significant financial implications during retirement.

Drawing from retirement funds:The rule of thumb is that you should withdrawno more than 4% to 6% from savings each year to make your money last a lifetime.

Study findings: Forty-four percent of respondents thought they could withdraw significantly higher amounts and still cover their needs.

Long-Term Care Costs: The cost of nursing care is one of the biggest wildcards in retirement. Maybe you'll need long-term care, maybe you won't. The key is taking it into consideration and understanding that such costs aren't covered by Medicare or health or disability policies. For help with daily challenges like bathing and dressing, you'll need to tap savings or a long-term care policy.

Study findings:Forty-two percent of respondents incorrectly believe that health insurance, Medicare, or disability insurance will cover long-term care costs.

Social Security:By now, everyone knows that relying solely on Social Security won't deliver a champagne lifestyle during retirement. But waiting to tap such benefits can raise the amount you receive. According to the study, a person who waits to collect Social Security until they're age 69, could see a benefit amount 24% higher than if they'd collected at age 66.

Reverse mortgages: Reverse mortgages have evolved and can be used to establish an emergency fund or serve as a source of income for homeowners who are 62 or older. Certain products even can be used to buy a primary residence. The HECM (Home Equity Conversion Mortgage) for Purchase, for example, lets older homeowners get funds to move closer to family or into smaller properties that better address their physical needs.

Such studies tend to send a chill down people's spines, particularly if they've not been saving. But by using information as a starting point and sitting down with a financial advisor (find a fee-only financial planner through the National Association of Personal Financial Advisors,www.napfa.org), you may be able to take steps now to ease your worries and to make your retirement years a bit more cushy.