1. With Special Steps for Those Living With Chronic Illness
Estate Planning in 12 Steps
With Special Steps for Those Living With Chronic Illness
By: Martin M. Shenkman, CPA, MBA, PFS, AEP, JD

2. Introduction to the 12 Steps
Every person is unique – it has to be your plan and address your challenges
Reflect your personal wishes and circumstances
Create a strong foundation of documents, steps and a plan to build upon

3. Action Step: 12 Steps Begin by Informing Your Advisors
Chronic illness affects every aspect of estate and related planning – don’t use “standard” documents or planning steps
You must explain your circumstances to all of your advisers or they will not be able to guide you
Larry’s story
Those not touched by chronic illness don’t understand the symptoms (96% are invisible), disease course, variability between diseases and among those affected by a particular disease

4. Step 1: Organize Emergency Information and Your Advisors
Contact People (names, numbers)
Financial Information (account information)
Passwords and Security Codes
Documents (Estate planning documents, legal documents, and more)
Budget and Plan

5. Action Steps: Emergency Info #1
Type up a list on your computer so you can update it
Disseminate the list to key people, ask for their help and tell them what they might need to do to help
Each professional adviser should have the list in their file

6. Action Steps: Emergency Info #2
Organize the list by category (e.g., banking, religious adviser, professional advisers, family, neighbors)
Give only the key facts someone will need to act in an emergency (person name, institution, insurance, office/home and cell number, , etc.)
List info needed for emergency action (e.g., account number, policy number, etc.)

7. Step 2: Designate a Person to Handle Financial and Legal Issues
Power of Attorney
Agent (Successors)
Compensation
Begin date (Trigger)
Powers (Authority)
Durability (Disability)

8. Action Steps: Power of Attorney
Choose a trusted agent and several successors
Hire a lawyer to draft powers that work for your disease course and financial situation
Discuss modifications to standard forms:
Limited power for short term hospitalizations and broad power for permanent disability)
Compensation
Definition of disability
Sign several originals, distribute them, organize and simplify assets so an agent can act easily and safely
Create a monitor relationship

9. Medical Power of Attorney
Step 3: Designate a Person to Make Health Care Decisions and Access Medical Records
Health Care Proxy
Medical Power of Attorney
Agent (successors)
Powers (religion)
Signature (State law)
Move (state; facility)

10. Action Steps: Health Care Proxy
Choose an agent and several successors who understand your health situation and wishes
Hire a lawyer to draft a health proxy that accomplishes your personal goals
Sign several originals, distribute them, be sure one is included in your medical chart
Discuss your decisions with family, friends and agents

11. Step 4: Communicating Your Health Care Wishes
Prepare a Living Will

12. Action Steps: Living Will
Review and consider personal wishes that should be reflected, e.g. religious observances, care instructions
Hire a lawyer to draft a living will that communicates your personal decisions
Discuss modifications to forms: Organ donations – e.g., CNS to foster MS research; Experimental or non-traditional treatment; Pain relief
Sign several originals, distribute them, be sure one is included in your medical chart
Discuss your decisions with family, friends and agents

13. Step 5: Protect Your Minor Child With an Emergency Child Medical Form
Disclose child’s care information

14. Action Steps: Protecting Children
Review all aspects of protecting your children with your advisers
Trustees under a revocable trust while you are alive and disabled and trustees and guardians under your will to provide care
Financial planning – 529 plans, resources
Personal letter of instruction
Directions in your power of attorney

15. Step 6: Sign a Will A legal document to designate
where your assets should
be distributed in the event of death

16. Action Steps: Sign a Will
Wills are important but if you’re facing a progressive chronic illness it is only one step of many and perhaps not the most important step
Include personal letters of instruction
Consider trusts for minor children
Include a donation to charities that have helped you – even modest donations send an important “thank you”

17. Step 7: Create a Revocable Living Trust
Establish a personalized (not boilerplate) living trust
Transfer assets to a trust during your lifetime
Probate and intestacy
Manage assets during disability or illness

18. Action Steps: Revocable Living Trust
See comments for “Wills” above and coordinate
Boilerplate Trusts designed to avoid probate won’t accomplish your goals
Focus of document should be protecting you and communicating your wishes as your disease progresses
Tailor trustee replacement, disability and other provisions to the nuances of your anticipated disease course

19. Step 8: Be Sure Your Insurance Coverage is in Order
Property and casualty insurance
Long term coverage
Disability income replacement
Life insurance
Liability

20. Action Steps: Insurance Coverage
Don’t make assumptions – get every insurance coverage reviewed at least every 2 years
Evaluate options – Can you convert term life insurance to a permanent policy? Can you sell life insurance in the secondary market to free up cash?
Standard may not work – do you need a rider for home health workers or home improvements?

21. Step 9: File Beneficiary Designations and Confirm Title to Accounts
Standard provisions are not always adequate
Coordinate with Revocable Trust
What powers should agent have
Give copies to your advisers
Update when banks merge
Revise when tax laws change

22. Action Steps: Beneficiary Designations
Consider all beneficiary designations: life insurance, pensions, IRAs, brokerage accounts and more
Obtain copies of the forms you filed and blank forms to facilitate revision
Have family members who name you as beneficiary consider a trust for you

23. Step 10: Give Back Demonstrate important values to heirs
Thank those that have helped
Inspire others to give

24. Action Steps: To Give Back
Make a donation (cash, stuff, insurance)
Include a bequest in your will – even small bequests can make a big statement
Write a heartfelt letter of instruction to heirs and thanks to those that have helped
Inspire others to give that have the wherewithal to do so

25. Step 11: Communicate Educate and inform your fiduciaries
Preparation of beneficiaries
Having a real conversation is one
of the most important steps you can take

26. Action Steps: Communicate
Explain your finances, family, care, disease, and so forth to your advisers – tell all so they can help properly
Discuss with family, friends or others involved in your life what help you might need
Can those you expect to rely on really help? Have alternatives
Express your wishes in face to face meetings and then confirm key points in writting

27. Step 12: Review, Revisit, Revise
Nothing remains static
Tax and property laws
Family situations
Assets and net worth
Health

28. Make an Action Plan
And Get Started

29. Protect yourself and
your loved ones