Deciding Directives

By Lorna Collier

Lorna Collier is a health and education writer whose articles have appeared in the Chicago Tribune, Next Avenue, USNews.com and many others.

www.lornacollier.com

Why end-of-life planning is essential for you and your loved ones

Kim Placentino loved Luigi “Louie” Caringello like a father. Placentino’s father had died when she was 2 months old, so Caringello, a longtime family friend, took on that role in her life.

When Caringello fell ill with congestive heart failure and chronic obstructive pulmonary disease, Placentino cared for him at his home, which was next door to hers in Lake Forest. She was also his designated power of attorney. During this time, the two talked frankly about Caringello’s final wishes — how he didn’t want life-prolonging measures, where he wanted his funeral and burial, and where to find his essential papers.

Caringello died in 2019, at the age of 83, with Placentino at his bedside. Losing him was a wrenching experience, but Placentino says she was comforted by the roadmap he had laid out for her.

“It brought me peace of mind and comfort after his death to not have to deal with so many decisions during a time of grief,” she says.

The case for end-of-life plans

Planning for the end of our lives isn’t something anybody looks forward to. Most people put it off. Yet, it’s essential for a variety of reasons: to ensure your estate is distributed as you wish; to relieve emotional and financial burdens on loved ones; and, ideally, to have a measure of control over how your final days play out.

“Death is a very scary thought for almost everyone because it’s the unknown,” says Katie Monahan, business development manager at Transitions Hospice, which provides hospice and palliative care throughout northern Illinois.

“We talk about planning a wedding or a graduation party or a baptism, but we never talk about planning our funeral,” she says. “We, as a society, are afraid to talk about death, but the best thing we can do is plan for it.”

Planning ahead was helpful for Placentino. And now — as director of community relations for Reuland & Turnbough Funeral Directors of Lake Forest — she provides care, support and education to others about how to plan a personalized funeral to honor a loved one.

When Caringello died, “I was grateful we had open discussions about his end-of-life plan and that it was formally documented,” Placentino says. “I knew exactly what his wishes were. That was the greatest gift he could have ever given me.”

Setting Up Advance Directives

End-of-life planning involves not just your funeral and what happens afterward, but how one’s last days are spent — what type of medical care and life-sustaining measures you want. Here are some key steps you can take right now.

1. Name your powers of attorney

With a power of attorney form, you can appoint a person to manage your property, financial or medical affairs if you become incapacitated. But you must be of sound mind when you set it up.

Too often, people wait too long to set up power of attorney, says elder law attorney Matt Margolis of Margolis Weldon LLC in Park Ridge.

“All the time, I have clients come to me and their mother is already incapacitated, so we can’t put powers of attorney together,” he says.

2. Make a wish

Advance directives tell doctors how you want to be treated if you, say, stop breathing or fall unconscious. They apply to medical treatment, not your financial affairs.

Living wills, which state your preferences regarding your healthcare while you are still living, are one type of advance directive. They can also express wishes for your final days and your funeral service, Monahan says. She recommends families use a document called “Five Wishes” to open conversations about what loved ones want.

Margolis says in his experience, doctors typically ask the holder of the healthcare power of attorney what to do, rather than seek out the living will. That’s because healthcare power of attorney gives a representative the ability to make medical decisions that the individual might not have predicted in a living will.

A Practitioner’s Order for Life-Sustaining Treatment (POLST) clearly lays out your treatment wishes in case of a medical emergency and is more legally binding than a living will, Margolis says. It’s a medical order signed by both you (or your representative) and your healthcare provider.

3. Have a will or trust made

If you don’t have a will or trust, your estate may have to go into probate — a process that, in Cook County, can take a year or more and cost as much as $10,000 for a simple estate, Margolis says. An attorney can set up a will or trust, along with powers of attorney. Done right, these measures help you avoid probate.

4. Make sure beneficiaries are updated regularly

Don’t forget to regularly update your will or trust, life insurance policy, 401(k) and anything else with a beneficiary, Margolis advises. Too often, people check off estate planning from their mental list, then don’t revisit it when recipients die or if there’s been a divorce. This can result in benefits not going where you want or in a potentially expensive court fight.

5. Communicate with your family

Pamela Martin runs Long World Services for the Living, a Chicago-based business that helps people downsize their homes or close homes for family members who have died. She suggests gathering your important papers, passwords and valuables, such as family heirlooms, and telling family members where these items are.

It’s important to update and communicate all these wishes before individuals are no longer able to do so. “It’s never too early to plan,” Margolis says. “But it can be too late. Plenty of times, it is too late.”

Resources

Five Wishes | National POLST | Power of Attorney, Illinois

Above Photo:  Kim Placentino and Louie Caringello.