By Peter Amsterdam
September 17, 2019
(This article builds on the preceding article, Aging and Death, 1. It addresses helpful practical matters regarding dying and death, and how to prepare.)
As we saw in Part 1 of Aging and Death, death came into the world because of Adam’s sin, and thus each of us will eventually die; and most of us will pass on after our bodies have weakened due to old age. While there is nothing we can do to prevent our death, there are some practical things each of us should do in preparation for our departure from this life and passing on to our heavenly reward.
The focus of this article will be on two practical matters which are wise to take care of in preparation for death. These points aren’t only important for those who are elderly, but for every adult, since none of us know the time of our passing. This article will address the wisdom and importance of having both an end-of-life medical directive and a Last Will and Testament.
One of the main reasons for creating these two documents is to save your loved ones from having to make unnecessary difficult decisions either when you are at death’s door or after you have passed away.
An end-of-life medical directive, also known as a living will, advance healthcare directive, or an advance directive, is a document that expresses your medical wishes should you become incapacitated and unable to communicate. Such directives help guide the decisions of the doctors and caregivers if you are terminally ill, seriously injured, in a coma, or in the late stages of dementia or near the end of life. Having such a document will make it easier for your loved ones as it will avoid placing them in the difficult position of having to make life-and-death medical decisions on your behalf. It will save your family members from the potential agony of having to decide what course of action to take and/or having possible disagreements with one another about decisions regarding your end-of-life care.
At the same time, having such a document can prevent you from being kept alive by artificial means when it is your desire to go to be with the Lord. It can also prevent your family spending a great deal of money to keep you alive when you are longing to pass on but are unable to make your wishes known. It is not enough to simply tell others in advance what you want to happen to you, should you ever be incapacitated. If it isn’t written down and signed by you (and in some countries, signed by two others who are not named in the document), then your desires may not be considered by medical personnel and the standard course of action in such cases may be that the medical system would opt to keep you alive for as long as possible by whatever means necessary. Having an end-of-life medical directive is the legal means of giving you a voice when you are unable to make your wishes known.
Generally speaking, a medical directive should address the following points:
Cardiopulmonary resuscitation (CPR). Do you wish to be resuscitated by CPR or by a device which sends an electric shock to stimulate the heart? Or do you prefer not to be resuscitated?
Mechanical ventilation. If you are unable to breathe on your own, do you want to be hooked up to a ventilation machine? If so, for how long do you want to be placed on a ventilator?
Tube feeding. It is possible to supply the body with nutrients and fluids intravenously or through a tube in the stomach. You would want to decide if, when, and for how long you would want this treatment.
Dialysis. Dialysis is a process which removes waste from your blood and manages fluid levels if your kidneys no longer function. Again, you would want to determine if, when, and for how long you would want to receive this treatment.
Antibiotics or antiviral medications. These are used to treat infections. If you are near the end of life, do you want infections to be treated aggressively or would you rather let infections run their course?
Comfort care (palliative care). This includes any number of interventions that may be used to keep you comfortable and manage pain while abiding by your other treatment wishes. This may include being allowed to die at home, getting pain medications, being fed ice chips to soothe mouth dryness, and avoiding invasive tests or treatments.
The end-of-life medical directive can, and probably should, name someone whom you have chosen to be your healthcare agent, who can act on your behalf if you are unable to. This is important because it’s impossible to anticipate all potential scenarios, and in some instances there may need to be a judgment made as to your likely care wishes. Such a person should be someone you can trust to make decisions which align with your desires and values. It would require that you discuss your medical care and end-of-life issues with this person. This could be your spouse, a family member, or a close friend.
Another way to assign someone the authority to act in your behalf, should you be unable to make your wishes known, is to sign a durable medical power of attorney document that designates a spouse, relative, or friend who is authorized to make medical decisions on your behalf.
Even without an end-of-life medical directive, you can inform your doctor to put in their records what your wishes are, such as that you do not wish to be resuscitated (DNR, Do Not Resuscitate), and/or that you do not wish to be intubated (DNI, Do Not Intubate). Intubation generally means to insert a breathing tube into the trachea for mechanical ventilation.
Each country/state will probably have different laws regarding end-of-life medical directives and durable medical powers of attorney, so you will need to research what is legally acceptable locally.
There are a number of benefits to having a will (or a similar legal document, such as a trust), whether you have many or few assets. Whether there is money in your bank account, a car, a house or property, or any other assets, it’s important that you have a will to determine who your assets go to.
The following is based on information regarding wills in the United States; in other countries, the laws concerning wills may be different. No matter where you live, it’s wise to familiarize yourself with the local laws regarding wills and inheritance.
Having a will makes the processing of your estate (meaning all of your assets) much simpler and faster after your death. It allows you to decide how your assets will be divided, as without a will the state will make that decision. If you have underage children, a will is especially important, as within the will you can designate who will gain custody of your children should both parents suddenly die.
Having a will allows the person who is designated as the executor of the will to take care of any necessary legal business, such as closing bank accounts, cancelling subscriptions, liquidating your assets, paying any last bills or taxes, accessing and cancelling email and other online accounts, etc. (A file containing such legal and financial information and passwords is helpful.) It’s possible to name an executor of your estate even if you don’t have a will; however, a will allows your wishes to be followed more precisely.
Many people avoid preparing a will because they don’t think they are going to die anytime soon. However, Scripture teaches that no one knows the hour of their death. Jesus told the parable of the rich fool who said,
“I will tear down my barns and build larger ones, and there I will store all my grain and my goods. And I will say to my soul, ‘Soul, you have ample goods laid up for many years; relax, eat, drink, be merry.’ But God said to him, ‘Fool! This night your soul is required of you, and the things you have prepared, whose will they be?’”1
In the book of Ecclesiastes we read,
No man has power to retain the spirit, or power over the day of death.2
Man does not know his time. Like fish that are taken in an evil net, and like birds that are caught in a snare, so the children of man are snared at an evil time, when it suddenly falls upon them.3
Following are 10 reasons for having a will according to FindLaw.com:
1. You decide how your estate will be distributed. A will is a legally-binding document that lets you determine how you would like your estate to be handled upon your death. If you die without a will, there is no guarantee that your intended desires will be carried out. Having a will helps minimize any family fights about your estate that may arise, and also determines the “who, what, and when” of your estate.
2. You decide who will take care of your minor children. A will allows you to make an informed decision about who should take care of your minor children. Absent a will, the court will take it upon itself to choose among family members or a state-appointed guardian. Having a will allows you to appoint the person you want to raise your children or, better, make sure it is not someone you do not want to raise your children.
3. To avoid a lengthy probate process. Contrary to common belief, all estates must go through the probate process, with or without a will. Having a will, however, speeds up the probate process and informs the court how you’d like your estate divided. Probate courts serve the purpose of “administering your estate,” and when you die without a will (known as dying “intestate”), the court will decide how to divide your estate without your input, which can also cause long, unnecessary delays.
4. Minimize estate taxes. Another reason to have a will is because it allows you to minimize your estate taxes. The value of what you give away to family members or charity will reduce the value of your estate when it’s time to pay estate taxes.
5. You decide who will wind up the affairs of your estate. Executors make sure all your affairs are in order, including paying off bills, canceling your credit cards, and notifying the bank and other business establishments. Because executors play the biggest role in the administration of your estate, you’ll want to be sure to appoint someone who is honest, trustworthy, and organized (which may or may not be a family member).
6. You can disinherit individuals who would otherwise stand to inherit. Most people do not realize they can disinherit individuals out of their will. Because wills specifically outline how you would like your estate distributed, absent a will your estate may end up on the wrong hands or in the hands of someone you did not intend (such as an ex-spouse with whom you had a bitter divorce).
7. Make gifts and donations. The ability to make gifts is a good reason to have a will because it allows your legacy to live on and reflect your personal values and interests. In addition, gifts up to $13,000 are excluded from estate tax, so you’re also increasing the value of your estate for your heirs and beneficiaries to enjoy. Be sure to check the current laws for your year to learn the most up-to-date gift tax exclusions.
8. Avoid greater legal challenges. If you die without a will, part or all of your estate may pass to someone you did not intend. For example, one case involved the estate of a deceased son who was awarded over $1 million from a wrongful death lawsuit. When the son died, the son’s father—who had not been a part of his son’s life for over 32 years—stood to inherit the entire estate, leaving close relatives and siblings out of the picture!
9. Because you can change your mind if your life circumstances change. A good reason for having a will is that you can change it at any time while you’re still alive. Life changes, such as births, deaths, and divorce, can create a situation where changing your will is necessary.
10. Because tomorrow is not promised. Procrastination and the unwillingness to accept death as part of life are common reasons for not having a will. Sometimes the realization that wills are necessary comes too late—such as when an unexpected death or disability occurs. To avoid the added stress on families during an already emotional time, it may be wise to meet with an estate planning lawyer to help you draw up a basic estate plan at the minimum, before it’s too late.
Death can come at any time, so it is wise and loving to take the time to make a legal will. Doing so is one of those duties which can easily be put off to another, more convenient time; however, it’s best to invest the time and work in preparing it now, for the sake of your loved ones.
Notes
Unless otherwise indicated, all scriptures are from the Holy Bible, English Standard Version, copyright © 2001 by Crossway Bibles, a division of Good News Publishers. Used by permission. All rights reserved.
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