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Advance Care Planning

Our society often uses euphemisms such as: “passed on,” “passed away” or even just “passed” to acknowledge when someone dies.  On a more pragmatic level, many Americans fail to plan for their own death, even though such an act could make the inevitable experience much easier to accommodate.  Many push planning for the ultimate life event aside until the last possible moment.  This can, and often does, create challenges for the family, especially with respect to final wishes and legal matters of the dying.  Treating death as if it were optional and not planning appropriately for the experience often results in dying being more challenging and complicated than it would otherwise be.

Aging, illness, dying, and death are as much a normal part of the human life cycle as are birth, joy, fulfillment, and intimacy.  Most of us experience fear facing a life-threatening condition.  We fear losing our freedom and dignity among many other forms of loss.  We fear burdening family members, making them feel guilty, maybe creating financial stress for them.  Studies show most of us want to die at home surrounded by family and friends, free from pain, attended to, and comforted through interactions with those we have shared life with.  However, the reality is, many end up receiving unnecessary medical care until the last moments in clinical settings or receiving custodial care in corporate owned nursing homes.  Many needlessly suffer physically, emotionally, and spiritually without the benefits of palliative care and attendance from loved ones.  Having a legal document stating wishes allows us to avoid many end-of-life dilemmas.

We all have a fundamental right to dignity of choice with regards to the way we live life and ultimately leave it.  Making medical choices consistent with our wishes and values is a part of maintaining our dignity in life and in death.  It is best to have choices in writing and to have had conversations with our loved ones and our care team before any crisis.  Once choices have been made, they need to be referenced and available for healthcare providers to act upon…it won’t happen unless it is written down.

Moreover, we each have the right to decide what quality of life (QoL) means to us.  While healthy, we are free to pursue activities that fulfill our personal definition of QoL.  But, with sudden illness, acute accident, or at the end of life, extreme measures are sometimes warranted.  Having to go on life support or receive aggressive treatments that cause more pain and suffering can and will affect our QoL.  When we consider what kinds of interventions we prefer when confronted with a health crisis or at the end of life, then communicate our wishes clearly in writing, it gives healthcare professionals direction for interventions.  For healthcare professionals, the best outcome is always the one that provides for the possibility of the highest quality of life for the patient.

Have you completed healthcare wishes and made them known to your loved ones?  Do you know their wishes about end-of-life issues?  Now is always a good time to consider options and complete an advance healthcare directive.  This simply means communicating the type of care you desire if you are unable to express it directly.  Clarifying your personal preferences in writing and then communicating them to your loved ones and healthcare providers can turn a potentially confusing set of decisions into a clear roadmap that your family members and doctors can apply.  Having an advance care directive facilitates:

  1. Ensuring your personal preferences are respected by your healthcare team.
  2. Taking the burden of responsibility off your loved ones from making health related decisions on your behalf.
  3. Having you experience end-of-life issues on your terms
  4. Providing you with peace of mind, knowing your wishes will be respected
  5. Addressing and clarifying religious or cultural beliefs in terms of medical interventions
  6. Improving quality of life, as you define it.

Once paperwork has been filled out, it is important that it is witnessed and signed by at least two people, neither of whom have to be a lawyer.

At completion, you should have a document, referred to an advance care directive document that clearly states your personal preferences for medical treatment under various circumstances.  You should also have specified in writing who you would like to manage your medical decisions through completing a durable power of attorney for healthcare or DPAHC.  Additionally, your set of documents for advance care directives should include a completed physician order for life sustaining treatment or POLST.  The documents along with your designated DPAHC advocate will ensure your wishes with respect to certain life sustaining interventions will be respected.

 

HELPFUL MATERIAL – planners/organizers, forms, articles

HELPFUL FEATURE DOCUMENTARIES

HELPFUL SHORT VIDEO CLIPS

BOOKS

ADVANCE CARE PLANNING ADDITIONAL RESOURCES

For more resources click [HERE].  Scroll down to the Advance Care Planning section