Preparing for the Unexpected: What to Know About Incapacitation

Life is unpredictable. I recently had a conversation with a friend about people we’ve personally known who passed away unexpectedly. What struck us the most was how many of these individuals had no known health issues, were relatively young, and were simply going about their ordinary day when the unthinkable happened.

There was the mother, age 53, who collapsed and died from a brain aneurysm while pruning trees in the family orchard; the mother of a friend who collapsed and died from a heart attack at the age of 58 while shopping in a department store with her daughter; and the cousin of a friend who died at the age of 27, collapsing on the sidewalk from a brain aneurysm while talking to her neighbors. I suspect almost everyone has a similar story they can tell.

These stories remind me it’s not just the elderly who need to think about estate planning - it’s for everyone. The reality is that we don’t know what tomorrow holds, and while we often think about planning for death, we don’t always consider what happens if we don’t die but are unable to make decisions for ourselves.

What Happens If You’re Incapacitated?

Not every unexpected event results in death. Some people experience a temporary or permanent incapacitation - meaning they are alive but unable to communicate or make medical and financial decisions. This could be due to a stroke, coma, dementia, or a severe accident.

If this happens, who will step in to manage your finances? Who will make medical decisions on your behalf? Without proper legal documents in place, your family may have to go to court to get permission to act on your behalf. This process can be expensive, time-consuming, and emotionally draining - especially in an already stressful situation.

Essential Documents to Have in Place

There are critical documents that everyone over the age of 18 - and regardless of health - should have in place to be prepared for unexpected incapacitation:

Advance Directive (also known as a Living Will)

This document outlines your preferences for medical treatment. Do you want to be kept on life support? Would you prefer not to be resuscitated under certain conditions? Do you have religious beliefs that need to be honored? An advance directive ensures that your wishes are known and spares your family from making heartbreaking decisions without guidance. This document also allows you to name a healthcare proxy - the person who will advocate on your behalf for the preferences you have expressed.

A Durable Power of Attorney allows someone you trust to manage your finances if you are unable to do so. This person can pay your bills, access your bank accounts, and handle other financial matters on your behalf. Without this document, your family may have to go through the courts to gain access to your finances, which can be a lengthy and costly process.

A Healthcare Power of Attorney allows someone to make medical decisions for you if you are unconscious or unable to express your wishes. Without it, doctors may have to rely on state laws that dictate who makes decisions for you, and that person may not be the one you would have chosen.

Why You Need Both an Advance Directive and a Healthcare Power of Attorney

Having both an Advance Directive and a Healthcare Power of Attorney (POA) is essential because they serve different but complementary purposes. An Advance Directive outlines your specific wishes regarding medical treatments, such as life support, resuscitation, and end-of-life care. It acts as a guide for your doctors and loved ones if you are unable to communicate your preferences. However, it may not cover every medical scenario, which is where a Healthcare Power of Attorney comes in. A Healthcare POA designates a trusted person to make medical decisions on your behalf when situations arise that aren’t explicitly addressed in your Advance Directive.

You can name the same person for both roles, but it’s important to choose someone who is comfortable making difficult medical decisions and who will honor your wishes, even under pressure. Legally, a Healthcare POA (sometimes called a healthcare proxy) has broader decision-making authority than what is covered in an Advance Directive. While an Advance Directive only applies in specific medical situations—typically when you are terminally ill or permanently unconscious—a Healthcare POA can make decisions in any circumstance where you are incapacitated, even temporarily. Having both ensures that your medical care aligns with your wishes while also allowing for flexibility in unexpected situations.

Take Control Now - Before It’s Too Late

I know these aren’t fun topics to think about, but the truth is planning ahead isn’t about expecting the worse - it’s about protecting yourself and the people you love. If something were to happen tomorrow, would your family know what to do? Would they have the legal ability to step in and take care of things?

If you haven’t put these documents in place yet, now is the time. Talk to an estate planning attorney about setting up your powers of attorney so that someone you trust can step in if needed. You can prepare an Advance Directive on your own, but it’s a good idea to discuss your options with a medical professional who can explain the pros and cons of different life-saving treatments. Also, be sure to check with the people you plan to name in these documents to confirm they are willing and able to take on these important roles.

Resources for Advance Directive

• Local Hospitals and Healthcare Providers - Many hospitals and medical clinics provide Advance Directive forms and assistance with completing them. You can also ask your primary care doctor or local hospital social worker for resources.

• AARP – The American Association of Retired Persons (AARP) website offers free, state-specific Advance Directive forms.

• Five Wishes – This nationally recognized advance care planning organization provides a more detailed directive that covers emotional, personal, and spiritual considerations alongside medical preferences. Their form is available in 30 languages!

Taking these steps now will give you and your loved ones peace of mind, knowing that no matter what life brings, your wishes will be honored and your family won’t be left guessing.