Dear Barbara, when do we talk about end of life issues with others?

We must talk about end of life issues NOW while we are healthy, and our thoughts are not clouded with fear. Right now when emotions don’t affect our thinking. When we can rationally set out details of how we want to live until we are dead. If we wait and do not talk about and write out our intentions, when end of life decisions have to be made, when life defining information is needed, someone else will be making the decisions. Family, significant others, doctors, medical staff will all be making decisions based on their own agendas. The result of their decisions may not be how we intended to live our final days. Remember if we don’t make our wishes known now the chances of our being physically able to make them when we need to are very slim.

An Advance Directive is the recognized tool for making our end of life decisions known. HOWEVER, it isn’t enough to have one written and put in a safe place if those who will be making decisions when you are unable don’t know what is written. You need to have a talk with your primary physician, while you are healthy (“when the time comes that I need this, here are my wishes”) Give your physician a copy. Also have the same talk with your family and significant others. Explain your choices and the forms to your family. Have discussions, share feelings. Be sure to let them know where you are keeping the form. You want everyone on the same page when it comes to your end of life decisions. Know that your loved ones will tend to want to have everything medically possible done to maintain your breathing. If that is also what you want, great. But, in many cases what we want and what our family wants for us is not the same. Talking with your physician and with all family members helps avoid disagreements at a time when emotions will be very high. This isn’t necessary but if you have a relationship with an attorney, or an estate planner, they should also have a copy.

Remember, the purpose of an Advance Directive is to have available our personal requests for medical treatment WHEN WE CANNOT speak for ourselves. An advance Directive is only applicable when we are not capable of speaking for ourselves. That situation may be the result of an accident, a medical and life threatening emergency, or the ending of a terminal illness.

Do an internet search for Advance Directives and there will be numerous web sites that offer information and forms to download.

There is another time that we want to have an end of life discussion with our family, significant others and physician---when we have been told that we have a life threatening, possibly terminal illness. When we are facing the end of our life, it will be a “refresher” conversation. A reminder of the thoughts and wishes put in place when we were well. We review the ideas we had when we were healthy to see if we have changed our mind.

We can ALWAYS change our mind with an Advance Directive. We can update it at anytime. The thing to remember is we won’t be able to make one if we are facing death and non responsive.

Something More about Taking Charge With An Advance Directive... That is why we do it now so we can take charge of our future. I have written information on this process in my book THE FINAL ACT OF LIVING and my guidebook, By Your Side, A Guide for Caring for the Dying at Home