Start the conversation
Some of the most tragic patients we see as nurses are those who are unable (or their family members are unable) to make decisions on what type of care they do or don’t want near the end of life.
This often results in futile and expensive care that causes pain and emotional distress for everyone involved.
It doesn’t have to be that way.
This week is National Healthcare Decisions Week, an initiative of The Conversation Project. Today, specifically, is about spreading the word, and sharing with others what you’ve thought about with regards to end-of-life care. So that’s what I’m doing!
It’s never too early to start thinking about end-of-life wishes, although it’s often too late. I’ve been talking to my husband about my wishes almost from the day we got married. Young people can be victims of freak accidents and illnesses that rob them of their ability to make decisions. Then the parents, spouses or siblings are left frightened and confused (and angry) about what to do next.
I did not want my family to be in that dreadful position. I needed my husband to understand what I would like done and not done, and feel confident about making those difficult decisions if I wasn’t able to.
I also encouraged him to talk to me about his wishes. (That’s what you get for marrying a nurse 😍)
Talking about your wishes with others who will be involved in any decision making, and having those wishes in writing, is a blessing to loved ones.
Help others help you.
There is no right or wrong plan
As long as it’s a plan.
And plans will change over time. What may seem rational for a twenty-something will probably not be the best course of action for an 85-year-old.
How do you start planning?
I suggest reading The Conversation: A Revolutionary Plan for End-of-Life Care by Harvard physician Angelo Volandes. To start “the conversation” consider these questions:
- What kinds of things are most important to you?
- What concerns do you have about getting sick or needing medical care?
- If you were very sick, are there any specific medical treatments that might be too much for you?
- What are your spiritual, philosophical, religious or cultural beliefs that would influence your medical decisions?
Then talk to your family. Dr. Volandes suggests a holiday dinner.
That probably sounds grim, but honestly some of the funniest conversations I’ve ever had have revolved around end-of-life planning. Black humor, maybe, but they were still funny.
More planning resources
Whether you’re very young and end of life is very far in the future, or you are feeling past your sell-by date and want all your paperwork ready to go, there are resources to help you.
I’ve read many books on this topic and written many posts. I’ve also listed some organizations on my Resources page.
My favorite books:
My favorite posts:
- End of life—”Five Wishes”
- End of life forms—Living wills, DNR and POLST
- A physician’s own end-of-life story
Life is 100% fatal. We shouldn’t live in denial or fear of death. Think about it; talk about it. You may find having a plan, even an extremely flexible one, gives you a feeling of control and lets you enjoy life that much more.