Greetings one and all! I hope you are doing well and enjoying the unfolding spring season. Once again, I invite you to take a deep breath, pour a cup of coffee or hot tea, and relax. In light of the upcoming National Healthcare Decisions Day on April 16, perhaps a chat about advance care planning is in order. Wait! I know what you’re thinking. This is NOT something you want to consider. Medical care options and end-of-life decisions are emotionally charged and daunting, to say the least. However, if we reframe the conversation, maybe you will be more inclined to embrace the planning process. Instead of thinking about various death scenarios, consider the infinite options for LIFE! Planning for LIFE is a much more appealing and productive approach. How do you wish to LIVE until the end of the road? To ensure that your wishes become your reality, you must plan well.
Over the past eleven years, I presented numerous programs on advance directives—legal documents that indicate preferences for medical care and end-of-life care that become effective when a person is incapacitated. Without exception, the greatest challenge was enticing people to attend. Most people just don’t want to “go there.” It is estimated that only 25-30% of people in the United States have completed advance directives. There are numerous factors contributing to our reluctance to plan: lack of knowledge, lack of urgency, fear of death and dying, distrust of medical systems, cultural incompatibility, emotional distress, and family dissension. However, if we fail to articulate our preferences related to medical care and end-of-life care, we relinquish control and often unduly burden family and friends. A distressing situation for all concerned.
So, we need to Plan for LIFE. The first step in the planning process is to “know thyself.” Identify your wishes for LIFE. Take the time to seriously consider your values, priorities, and preferences in life. Consider the following questions in relationship to a healthcare crisis or to advanced age:
- How do you wish to LIVE (define an acceptable quality of LIFE)? For example:
- Physically active
- Mentally astute
- Capable of communicating
- What are your hopes? For example:
- Remain at home
- Be surrounded by friends and family
- Retain a sense of control
- Be treated with dignity and respect
- Experience well-managed pain and symptoms
- What are your fears? For example:
- Loss of control
- Loss of relationships
- Physical suffering
- Loss of dignity
- Loss of meaning and purpose
- Financial ruin
- Being a burden
- Who—without a doubt— will represent your wishes (Medical Durable Power of Attorney)?
The second step in the planning process is critically important—discussing your Plan for LIFE with family and friends. I can’t stress this enough! Family and friends need to hear your LIFE wishes. Having THE conversation with loved ones affords the opportunity to articulate your preferences, answer questions, and discuss concerns. Additionally, your willingness to “go there” may encourage others to follow in your footsteps. A good thing indeed! There are some fabulous online resources to assist in kick starting THE conversation:
- The Conversation Project: http://theconversationproject.org/
- Caring Conversations: https://www.practicalbioethics.org/resources/caring-conversations
- Caring Connections: http://caringinfo.org
Finally, document your Plan for LIFE. Advance directives consist of a variety of legal forms including : living will, CPR directive, Medical Durable Power of Attorney, MOST, POLST, 5 Wishes, etc. It is important to determine the legally recognized and required documentation as mandated by your state of residence. Seek legal counsel if needed.
If you are still reluctant to “go there,” let me say one more thing. Advance directives are NOT all about YOU! Investing the time and attention to create a Plan for LIFE results in one of the greatest gifts you could ever offer your family and friends. A well-conceived Plan for LIFE will guide and advise those who care for you at the end of the road—mitigating some of the inevitable uncertainty and angst. For me, that is motivation enough to Plan for LIFE! I hope it motivates you as well.
I look forward to the ongoing conversation. If you have specific questions or concerns related to your caregiving experience, I would love to hear from you. Until the next posting, I wish you and yours countless blessings…jane
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