How Advanced Care Planning Helps You -- and Your Family

The thought of making and communicating your decisions about the level of medical care you want at the end of your life can be difficult. After all, few of us are comfortable talking about our mortality, and even fewer of us want to talk about losing mom, dad or our grandparents. However, making and documenting your decisions helps to assure your wishes are known, and takes a burden off your family members at a very trying time.

“If you're unable to speak for yourself, you want someone who will speak for you,” says palliative care coordinator Dionne Suttell, RN. “There comes a time when a person has declined to the point that anything their health care providers do will not bring them back to fully functional. You don't want your body – or your loved ones – to go through a long and ultimately futile hospitalization.”

When it comes to advanced care planning, it's important to talk with your entire family. That way, everyone has firsthand knowledge of what you want, and how you came about these decisions, often making it easier for family members or trusted friends to follow your instructions. It's also likely to lessen any friction between those you've appointed to carry out your wishes and other loved ones.

Talk Before the Crisis

Advanced care discussions should take place before a crisis happens, Ms. Suttell says. The opportunities to open up a dialogue on end-of-life wishes include:

  • When drawing up a will or doing other estate planning
  • When a friend or other family member is facing a similar concern
  • At holidays when the family is together
  • At the time of marriages, births, retirement, anniversaries and other significant life events
  • When illness requires you or a family member to move from home to a long-term care setting

“When I talk to patients about having an end-of-life discussion with their loved ones, I suggest having it during a family meal or possibly at a family get-together,” Ms. Suttell says. “There is no better time than when you are surrounded by loved ones in a place you feel comfortable and safe.”

Go Slow

Still, this can be stressful for all concerned, so take your time. Outline what you want done and why you decided to do one thing but not another. Realize too that younger loved ones may not want to acknowledge that you're mortal and won't always be with them. They might insist that everything that can be done for you will be done. By letting them talk this out with you, it can often result in everyone feeling more comfortable when the final time comes, Suttell says.

“Even if the parents are nearing 100 and the children are in their 80s, it is still difficult,” she says. “This is something that nobody really wants to talk about, but it is a very necessary part of life.”

The National Hospice and Palliative Care Organization says this conversation can take pressure off the people you have designated as your agents. When you let everyone know this is your decision and that the person you've designated as your proxy is following your instructions, it lessens the burden on them to fulfill your advance care plans.

Write Your Wishes Down

Once these discussions have been completed, write them down. A Health Care Power of Attorney (HPOA) is a legal document outlining what your wishes are should you be unable to make them known. It is also used to appoint an agent who is responsible for making sure your desires for health care treatment – or stopping treatment – are followed.

“The HPOA agent is just someone you've asked to speak on your behalf about your health care wishes,” Ms. Suttell says. “Hospitals, physician offices, hospices and some senior services centers have blank forms with someone there who can help with the process.”

Elder care attorneys, although not required for these forms, are another resource. They can also work with you on other end-of-life issues, such as who will take over your financial affairs if you can’t, setting up wills or living trusts and/or Medicare and Medicaid concerns.

“It's better to be proactive than reactive,” Ms. Suttell says. “I know people don't like to talk about these issues, but in the long run, it's important to have end-of-life talks to know what you want to happen if you're too ill to make those decisions on your own.”

Dionne Suttell, RN is palliative care coordinator at the University Bedford Medical Center. You can request an appointment with any University Hospitals health care provider online.

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