Sunday, April 13, 2014

End-of-Life Decisions: Make Them BEFORE They're Needed!

I hate to be the one to break it to you ... but someday you will die! I absolutely guarantee that we all will eventually complete the circle of life and die, whether we like it or not and whether we are ready or not. But you can make that event more peaceful for you and your family by thinking about and discussing your end-of-life preferences ahead of time ... like NOW. Do it now ... before you are in the midst of an emergency or an emotion-packed situation.  

Actually April 16 has been designated as National Healthcare Decision Day, and that would be a great day to have THE discussion with your family. Talk with your physician if you need more information ... but don't wait. It is something easy to put off because no one wants to think about or talk about your death or that of a loved one ... but don't delay it any longer. 

Death does not discriminate

The discussion you will be having now about your end-of-life choices with your family is difficult, but decisions made in the heat of battle are painful beyond words. Just trust me on that! 

You might think you are too young to be worrying about end-of-life stuff, but unfortunately you never know when it will be needed. Death doesn't just come to old people. The kids killed in a school bus accident didn't plan on dying so young; the kids killed in a high school shooting didn't dream that their lives would be so short; the young adults killed in a traffic accident didn't think their lives would abruptly stop. My Jaime didn't believe that cancer would end her life before her 30th birthday. 

Legal responsibilities and beyond

Whether you are perfectly healthy or have a terminal illness, whether you are young (but older than 17) or old, the time to get your legal affairs in order is NOW! You need to get a will, even if very simple. And you need to get power of attorney papers drawn up (medical and financial) that state who you want making your medical and financial decisions for you if you are unable to do so. 

It is also important to have a living will or advance directive, which should indicate how aggressive you want the intervention by medical providers to be and what type of limitations, if any, you want made on life-saving measures? 

Depending on your circumstances you may not be able to think clearly at the end of your life or you may not be able to communicate. So communicate your choices and preferences now. Remember that these legal documents are not written in stone and can be changed as your life changes.

Also, as part of your plan, let your family know about other end-of-life things that concern you, like if you want to die at home if possible; let them know how you feel about being placed in hospice or a nursing home. Have you considered whether you want to be an organ donor if that is possible?

End-of-life wishes for after death

While you are at it, since this discussion is emotional already, discuss with your family what you would like to happen after your death. Be sure to have someone write down your wishes so there is no confusion later. It will save your family from making these decisions during a painful time when they want so badly to do what you would have wanted ... but they aren't sure what that is. 

Do you want to cremated or buried? What would you like to happen with your ashes? Do you have a preference of where you want to be buried? Do you want the casket open or closed? Do you have any special preferences for your funeral, like songs, or flowers, or people to speak, or poems or scripture to be read? Is there some special clothing you want to be buried in or something special you want buried with you (a photo or memento, maybe)? 

I know this all sounds morbid and depressing, but your family will appreciate having these guidelines when the time comes, especially since all family members may not agree with some of your choices. Many families today are multireligion and multicultural, with customs or beliefs that may not agree with your wishes, so it is important to make your preferences known. It is, after all, your death. 

Why should you take action NOW?

I feel very strongly about this topic of end-of-life discussions and decisions because of my personal experience. Many of you know that my daughter Jaime died of melanoma when she was 29. She was diagnosed 9 years earlier so we had plenty of time to get her legal paperwork in order ... but she balked. She was not going to die, she would declare ... she was too young to die. Jaime was simply unable to face the fact that she might ever need these legal documents; it was part of her coping mechanism. Many times over the years we tried to convince her that it would not hurt to have these legalities taken care of and then filed away until she died of old age. But she resisted.

Finally in the hospital during her last few weeks of life, her oncologist brought the subject up once again because he needed a legal medical power of attorney. She was furious with the doctor because to talk about end-of-life decisions at that point, in her mind, meant she was giving up ... and she had no plans to do that. 

However,  her daddy and I knew it was necessary and asked our family attorney to come to her bedside. It was a horrible experience at its best!! I had to ask the nurses to withhold Jaime's pain medication until after the attorney left so she would be lucid enough to sign the documents. At this point in time, when she was not ready to give up hope, we were shoving documents in her face about her impending death. Everyone was in tears, including the attorney. Wow, if we had only insisted that she take care of this before things got to this point. 

Following that, Jaime and I were able to talk about her wishes for after her death, and I think she must have been happy with the special "going away" party that we arranged for her. I am so thankful that I had her guidance with that, but it wouldn't have happened if we had not had THE discussion, as painful as it was.

Please take advantage of National Heathcare Decision Day or whatever day you choose to make your end-of-life decisions. It does not mean that you are near death or even facing it in the next 100 years. It does mean, however, that you are smart and prepared and care about your family by taking that burden off their shoulders. Just do it ... make your plan and then file it away and move on with living your life.

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