Advanced Directives and Why YOU Need One
Talking about Death can bring greater meaning and peace to your Life.
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It’s not a matter of if you will die, but when. Talking about death will not hasten death, but rather can remove some of the fear surrounding the end-of-life, which is a natural process every living thing goes through. Talking about your wishes and asking about your family’s wishes is truly the best gift you can give to one another.
One study found End-of-life discussions were NOT associated with patients feeling “depressed,” “sad,” “terrified,” or “worried.”
“We’re all going to die” from What About Bob (one of my favorites!)
Who Needs an Advance Directive? YOU DO!
It may seem morbid and ‘too sad’ to talk about the worst-case-scenario, but many people experience relief after talking through their end of life wishes with their families. An Advance Directive is truly the most helpful and precious gift your parents can give to you and you, in turn, for your family.
An Advance Directive is “a legal document that allows you to list your preferences for medical decisions in the event you are unable to communicate or make decisions for yourself.” You can also include preferences, such as if you would like to be buried or cremated. Five Wishes is a great tool to help you work through what your wishes might be and explain the choices. You could also go with the original Advance Health Care Form instead (we are working through California’s in the video below).
Death is the Ultimate Unknown
It’s understandable that death can be terrifying to think about and it’s because you can never speak to someone who has physically died. It is the ultimate unknown. As a nurse, I have seen so many people of all ages have their lives turned upside down in the blink of an eye. I would encourage anyone reading this, no matter your age, to think about what your wishes are for life-threatening situations and talk to your partner and family about the same. It is kind and wise to make sure your wishes are known, so that if (God forbid) you are not able to make medical decisions for yourself, your family won’t have to guess during an incredibly stressful and traumatic time (and then second guess and feel burdened if they don’t think they “guessed” right). This frees up your loved ones from arguing amongst themselves and adding undue stress during a time they should be focusing on being present and supporting you.
Our culture needs to find a new way of thinking about death. There is comfort and power in talking about death. It is a universal human experience and if we don’t think about what having a “good death” means to us and our loved ones, it’s much more difficult to have one. I have probably been with about 50 people as they have passed from this realm. I was the nurse that would come when any patient on our floor passed away to assess the patient and declare time of death (I went to a class called “Decedent Affairs” so we could learn how to declare a patient deceased, but thought I had signed up for a class called “Decadent Affairs,” where we would learn how to make patient’s birthdays special…a story for another day).
For me, a good death would consist of being surrounded by loved ones and being comfortable. What do you think a good death looks like for you? Would you rather die in the hospital? Or at home?
LIVING WITH ADVANCED CANCER
There is a huge gray area with medical care where physicians don’t want to give ‘false hope.’ Ambiguity when discussing treatments for advanced cancer can lead patients to misunderstand the purpose of treatments prescribed and receive medical treatments that they may not actually want if they understood all of the information. “What is the goal of the treatment (surgery or chemotherapy) you are recommending?” is a great question to ask your physician if you are ever diagnosed with cancer. The answer unfortunately may be only to extend survival by a few months, and some people may choose to not undergo a big surgery or taxing chemotherapy treatments in that case.
For certain well-defined terminally ill populations, patients who choose hospice care live an average of 29 days longer than similar patients who do not choose hospice.
PALLIATIVE CARE
Palliative Care is Aggressive Symptom Management for anyone undergoing cancer treatments (or other chronic illnesses). It is usually a team of physicians, nurses, and social workers who work with a patient to adjust medications for pain, nausea and other symptoms which someone is undergoing treatment. They also provide emotional support, resources, and care planning.
HOSPICE CARE
Hospice Care is symptom management, resources, care planning and emotional support for anyone who is expected to live 6 months or less. Someone who has signed onto hospice service is essentially saying “my goal is no longer to live and receive treatment at any cost. My goal is to be as comfortable as possible with whatever time I have left.” Patients on hospice do not receive treatments that are intended to cure, but only treatments that support the goal of comfort.
The End Of Life Act: If you are curious or interested in learning more about the End of Life Act,
please click here.
Additional Resources
“End Game” Documentary on Netflix
Considering DEATH can positively impact your LIFE
I have never visited a Death Cafe meeting, but I am a true believer that talking about death can greatly impact your perspective on how you want to live your life. As Dr Laura always says “between now and dead, how do you want to live your life?”
“At a Death Cafe people, often strangers, gather to eat cake, drink tea and discuss death.
Our objective is 'to increase awareness of death with a view to helping people make the most of their (finite) lives'.
A Death Cafe is a group directed discussion of death with no agenda, objectives or themes. It is a discussion group rather than a grief support or counseling session.”
For more information, visit DeathCafe.com