If you are age 65 or older — or you care for someone who is — planning for medical decision-making is no longer optional.
Serious health events can happen suddenly, and when they do, your ability to speak for yourself may be temporarily or permanently lost. A Combined Directive for Health Care ensures that your wishes are known, respected, and legally enforceable – even when you cannot communicate them yourself.
Why is this urgent for adults 65 and older?
The risks facing adults 65 years or older require planning and care – the possibility of health complications are not theoretical. They are statistically significant and increasing.
• Dementia affects nearly 1 in 3 adults over age 85, and millions of adults over 65 live with mild cognitive impairment that can suddenly worsen after illness or injury.
• Falls are the leading cause of injury-related death among adults 65 and older. Each year, more than 14 million older adults report a fall, often resulting in hospitalization and loss of decision-making capacity.
• Stroke risk increases significantly with age. Stroke remains a leading cause of long-term disability and can instantly impair speech, cognition, and judgment.
• Older adults face higher risks of post-operative complications. Delirium, cognitive decline, and loss of capacity after surgery are common in patients over 65, even when surgery is planned and routine.
These events often happen without warning — and they are exactly the moments when healthcare decisions must be made quickly.
What is a Combined Directive for Health Care?
In New Jersey, a Combined Directive for Health Care is a single legal document that does two critical things:
1. It names the person who will make medical decisions for you if you are unable to do so.
2. It clearly states your wishes about medical treatment so those decisions align with your values.
Key Components Explained
Proxy Directive (Healthcare Representative)
This section allows you to appoint a trusted adult to act as your healthcare decision-maker if you lose capacity.
Your representative communicates with doctors, reviews treatment options, and makes decisions guided by your expressed wishes and best interests.
Instruction Directive (Living Will)
This section documents your preferences regarding specific treatments such as life support, ventilators, feeding tubes, resuscitation, and overall care goals. It also allows you to express broader beliefs and values that should guide your care in serious illness or end-of-life situations.
Why Combining Both Components is Important
When these directives are combined into one document:
• Your representative has clear guidance
• Your medical providers have legal direction
• Your family avoids confusion, stress, and conflict during critical moments
How the Directive Works
• The Combined Directive only becomes active when your doctor — and sometimes a second physician — determines that you lack the capacity to make healthcare decisions.
• You remain fully in control while you are competent.
• You may modify or revoke the directive at any time.
Why Waiting is a Risk
Without a Combined Directive in place:
• Hospitals may default to statutory rules or internal policies.
• Loved ones may disagree about your care.
• The person you assumed would make decisions may not have legal authority.
Next Steps
For adults over 65, proactive planning is one of the most important gifts you can give yourself and your family. Legacy Trust and Capital Partners assists clients in creating Combined Directives for Health Care that are:
• Legally compliant in New Jersey
• Clearly written and customized
• Aligned with your values and long-term planning goals
This planning is not about age — it is about control, dignity, and peace of mind.
If you are 65 or older and do not yet have a Combined Directive for Health Care, now is the
time to act.
This commentary reflects the personal opinions, viewpoints and analyses of the Legacy Trust & Capital Partners employees providing such comments and should not be regarded as a description of advisory services provided by Legacy Trust & Capital Partners or performance returns of any Legacy Trust & Capital Partners client. The views reflected in the commentary are subject to change at any time without notice. Nothing in this commentary constitutes investment advice, performance data or any recommendation that any particular security, portfolio of securities, transaction or investment strategy is suitable for any specific person. Any mention of a particular security and related performance data is not a recommendation to buy or sell that security. Legacy Trust & Capital Partners manages its clients’ accounts using a variety of investment techniques and strategies, which are not necessarily discussed in the commentary. Investments in securities involve the risk of loss. Past performance is no guarantee of future results.
