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“It always seems too early, until it’s too late”

We plan for many things in our lives, and one of those things should be what we want to have happen at the end of life. Advance care planning means a lot more than filling out documents. It’s also about having ongoing conversations with your loved ones concerning your healthcare so you’re prepared if there is a time you are unable to make your own medical decisions. This is a gift to your family. Without the conversation, there can be confusion, conflict and guilt in a situation that is already very stressful. With a plan in place, you can focus on the things that matter.

How do you start the end-of-life conversation? Here are a few tips from the National Hospice and Palliative Care Organization (NHPCO):

One way to approach the subject is to talk about why you have decided to talk about these issues. For example:

  • Did a particular event cause you to make the decision?
  • Did an article in the newspaper or something that happened to a family member make you think about it?
  • What is motivating you to take these actions now?

Sometimes sharing your personal concerns and values, spiritual beliefs, or views about what makes life worth living can be as helpful as talking about specific treatments and circumstances. For example:

  • What aspects of your life give it the most meaning?
  • How do your religious or spiritual beliefs affect your attitudes toward dying and death?
  • What is your view towards death?

Sharing your end-of-life care decisions with your loved ones will also help them ensure your wishes are followed. Decisions may include answers to the following questions:

  • How important is it to you to be physically independent and stay in your own home?
  • Would you want your healthcare agent to take into account the effect your illness has on any other people?
  • Would you prefer to die at home if possible?

Advance care planning also includes having the conversation with your healthcare providers. NHPCO shares a few things to keep in mind when you discuss your concerns and choices:

  • Ask your doctor to explain treatments and procedures that may seem confusing before you complete your directives.
  • Talk about pain management options.
  • Let your doctor know that you are completing your advance directives.
  • Make sure your doctor is willing to follow your directives. The law does not force physicians to follow directives if they disagree with your wishes for moral or ethical reasons.
  • Give your doctor a copy of your completed directives. Make sure your doctor knows the name and telephone number of your appointed healthcare agent.
  • Assure your doctor that your family and your appointed healthcare agent know your wishes.

A few questions you can ask your healthcare provider are:

  • Will you talk openly and candidly with me and my family about my illness?
  • What decisions will my family and I have to make, and what kinds of recommendations will you give to help us make these decisions?
  • What will you do if I have a lot of pain or other uncomfortable symptoms?
  • How will you help us find excellent professionals with special training when we need them (e.g., medical, surgical and hospice and palliative care specialists, faith leaders, social workers, etc.)?
  • Will you let me know if treatment stops working so that my family and I can make appropriate decisions?
  • Will you still be available to me even when I am close to the end of my life?

Cedar Valley Hospice can help if you are ready to have these conversations or need assistance filling out your advance directives. We also can speak to your group, organization or congregation about advance care planning and provide copies of Five Wishes. For more information or to schedule a presentation, contact us today or call 319.272.2002.

The following are more resources on advance care planning and advance directives.