The Vancouver Sun published a letter from on April 24, 2013 that has caught my eye –

Ms. Zimmerman’s letter and concerns were motivated by a conversation with her financial advisor initiated at the request of his supervisor.  The conversation was about a suggestion for Ms. Zimmerman to appoint a power of attorney (POA) for property, given her age (an octogenarian).

Point 3 of 3 is addressing these specific sections of the Vancouver Sun letter:

Other societies may have spiked similar aging heights but this is the first time in history that we are aging en masse. This undoubtedly means major challenges, most of which are probably manageable. The response in the media, TV, and articles almost incessantly beat the ageist drums, seeing population aging as a crisis.

The emphasis ranges from the idea that an aging population will threaten our public programs, if not our entire economy. “The Grey Tsunami” or aging as a “time bomb waiting to explode” are by now familiar references.

….and later in the letter ….

This is utter rubbish, given recent studies expounding a theory of the “compression of morbidity,” meaning it is the last 30 days of life when dying occurs that generates high medical needs and more expensive care.

….and further on in the letter ….

Most of us are healthier, better educated and productive both economically and socially. We don’t decline when we turn 65; in fact we continue to develop and create innovative new ways of being older.

My comments for point #3:

3.      Is compression of morbidity a satisfactory argument against a POA?

The argument put forward by Ms. Zimmerman is that the last 30 days of life are the sickest and the costliest.  This may be true but this is not compression of morbidity which refers to a later onset of health problems, and, therefore hopefully fewer years of ill health before death.  Unfortunately compression of morbidity has not been achieved.  Although we are healthier at much older ages than ever before, our over medicalization of disease management, especially towards the end-of-life has resulted in the prolongation of life.  This is a whole other topic about autonomy, quality of life and dying.  It is sufficient to say for this particular blog that we have no certainty that our time in a state of illness will be shorter than it has been for previous generations.  And regardless of our health, education, and other characteristics, things do happen at varying times and it can be sudden regardless of age.

From a practical perspective, especially when dealing with chronic diseases which are what older individuals are more likely to face – the 30-day window at end-of-life is nearly impossible identify.  Even if we could identify this window it does not ensure capacity at that time to draw up a POA.  We need POAs, preferably both for personal care and continuing property (for incapacity) care, in place today.  The POAs protect you by having someone(s) you trust making decisions when you are incapable for any reason.  This helps to ensure that our wishes can be carried out and access to finances will not be restricted should we become unable to act on our own behalf.