Americans are increasingly focused on their health and wellness, spending billions of dollars per year on products and services such as gym memberships, fitness trackers, healthy foods, supplements, and alternative medicine.1 Mindfulness and meditation practices are also becoming mainstream2 as Americans pay more attention to their mental health, while telehealth lets us connect with healthcare providers whenever and wherever we need them.
This greater emphasis on our physical and mental well-being, however, stands in stark contrast to our lack of advance healthcare planning. While some Americans are diligently counting their steps, watching what they eat, and trying to live longer, healthier lives, many have failed to plan adequately for their future healthcare and what could happen in a medical emergency. One simple list can help address this shortcoming.
The Healthcare Planning Gap
The COVID-19 pandemic accelerated the trend of Americans taking a more proactive role in their health.3 It also prompted more Americans to create estate plans as we contemplated our mortality.4 However, the percentage of Americans with a will has since fallen back to prepandemic levels of around one-fourth.5
The number of people who have created a healthcare power of attorney is slightly higher than those who have created a will, but not by much. According to a study by Penn Medicine, the systematic review of approximately 795,000 people in 150 studies found that only 29.3 percent had completed an advance directive, including just 33.4 percent who had designated a healthcare power of attorney.6
The lead researcher in this study said that this lack of surrogate decision-makers and end-of-life care instructions means that the treatments most Americans would choose near the end of their lives are often different from the treatments they receive—a disconnect that can lead to “unnecessary and prolonged suffering.”7
Ensure That Clients Get the Care They Need—and Want
Clients who do not plan for medical contingencies, from sudden illnesses or injuries to gradual declines in cognitive abilities, could be forfeiting the ability to express their treatment preferences.
They might not realize that, absent medical directives such as a healthcare power of attorney, doctors may be forced to make critical decisions without a clear understanding of their wishes. This can lead to delayed care, unwanted treatments, family disagreements over the best course of action, and court intervention in some situations.
Even if a client has a power of attorney for healthcare, this document alone may not be enough to ensure that the treatments they receive are the ones they need—or would choose themselves. It may be necessary to have an advance directive or living will to help elaborate on the client’s wishes.If your state does not recognize advance directives or living wills as legally valid, your client can still leave a letter of instruction to their healthcare power of attorney to share their thoughts and desires.
While your clients may have authorized a trusted person to make medical decisions on their behalf when health problems prevent them from making or communicating those decisions themselves, their healthcare proxy (their agent) needs additional context to make the appropriate choices. This should be organized in a document that lists the following information:
- Doctor’s name and specialty. In a stressful situation, seemingly obvious details like these can be easily forgotten.
- Doctor’s contact information. Include the office phone number, after-hours contact number (if available), and the provider’s office address.
- Current health conditions. List any chronic illnesses or ongoing medical concerns the doctor is managing.
- Medication list. Provide a complete and up-to-date list of all medications, including dosages, frequencies, and the reasons they are being taken.
- Healthcare power of attorney. Confirm that a healthcare power of attorney is on file with the doctor’s office.
- Insurance information: Knowing the details of their insurance information and coverage can facilitate timely access to care and billing.
In addition to the provider’s office, it is a good idea to store a healthcare power of attorney in several other strategic locations, such as the agent’s home, with trusted family and friends, and at an attorney’s office. The client might hold on to the original, but copies and digital files can ensure access in an emergency.
You can also make yourself available to support the client and their agent in the event of a health crisis. For example, depending on your areas of expertise, you can help them navigate medical expenses, health insurance coverage, claims filing, Medicaid eligibility, financial planning, and related concerns.
By having a conversation with your client about advance directives and how they fit into their long-term planning goals, you can strengthen your position as an advocate for the client, their agent, and their family.
For younger, healthier clients, you can mention the disconnect between the growing emphasis on wellness and the relatively low rates of advance care planning. They may be focused on optimizing their health today, but what about their future healthcare? Older clients, especially those with a chronic illness, can also be (gently) reminded that they are at higher risk for critical illness and death and need documents addressing these concerns.
The wellness market offers significant business opportunities. Gaps in clients’ healthcare planning open up potential areas where advisors can collaborate for our mutual benefit and the benefit of our clients. Contact us to discuss advance directives and how we can work together on client plans that address all aspects of their well-being, now and tomorrow.
- Shaun Callaghan et al., Still Feeling Good: The US Wellness Market Continues to Boom, McKinsey & Co. (Sept. 19, 2022), https://www.mckinsey.com/industries/consumer-packaged-goods/our-insights/still-feeling-good-the-us-wellness-market-continues-to-boom. ↩︎
- Nat’l Ctr. for Complementary & Integrative Health, Meditation and Mindfulness: Effectiveness and Safety, NIH (June 2022), https://www.nccih.nih.gov/health/meditation-and-mindfulness-effectiveness-and-safety. ↩︎
- New CVS Health Study Finds People Are Taking Greater Control of Their Health As a Result of the Pandemic, CVSHealth (July 8, 2021), https://www.cvshealth.com/news/community/new-cvs-health-study-finds-people-are-taking-greater-control-of.html. ↩︎
- Daniel de Visé, Facing Mortality, More Americans Wrote Wills During the Pandemic. Now, They’re Opting Out, USA Today (Apr. 3, 2024), https://www.usatoday.com/story/money/2024/04/03/fewer-americans-writing-a-will/73170465007. ↩︎
- Victoria Lurie, 2025 Wills and Estate Planning Study, Caring (Feb. 18, 2025), https://www.caring.com/caregivers/estate-planning/wills-survey. ↩︎
- Two Out of Three U.S. Adults Have Not Completed an Advance Directive, Penn Med. (July 5, 2017), https://www.pennmedicine.org/news/news-releases/2017/july/two-out-of-three-us-adults-have-not-completed-an-advance-directive. ↩︎
- Id. ↩︎
