Creating Your Advanced Directive: Will Your Final Wishes be Granted upon Your Death?

This post is sponsored by Carla Baum of Meaningful Life and the content is based upon my opinions and experience. Visit my disclaimers and disclosures for more information.

None of us wants to think about the end of life. Not unless we absolutely have to. When we are forced to, unfortunately, the issues become a last-minute situation which barely cover the depth of our desires.

Or the wishes of someone we love.

In a recent conversation with Carla Baum, founder of Meaningful Life, and following the death of my parents, I have a greater appreciation for the need of end-of-life discussions and advanced directives, also called a living will or a healthcare directive.

A tale of two directives: which would you prefer?

Scenario 1:

Richard and Sue were always concerned about privacy and fraud. They shared none of their personal life, health, or financial status with friends, family, or their children. Richard and Sue had a will, but no advanced directive. When Richard became incapacitated due to an in-home fall, Sue was quickly overwhelmed with all the requirements for Richard’s daily living issues, in addition to her own grief. Whenever a health specialist, a hospitalist, or hospice personnel asked what Richard’s wishes were, Sue replied, “We were too afraid to discuss it.” As a result, all life-prolonging procedures were performed because Sue was too distraught to deny anything. By the time of his death, Sue had spent nearly half of their combined retirement savings. When Sue became ill, her eldest child gently advised Sue to share her wishes with at least one of the children so that someone knew her final requests. Unfortunately Sue refused and when she died, the children had no idea how to manage her final affairs. The situation created vast amounts of stress for the eldest child, exacerbated by two younger siblings who argued on how to manage their mother’s final affairs.

Scenario 2:

Gary and Anna arranged their will, powers of attorney, and advanced directives soon after their fourth child was born, in the early 1970s. When Anna developed Alzheimer’s disease in the early 2010’s, Gary and Anna shared their POAs and advanced directives with their children. Although it was an emotional time, the family discussed concerns and worked through any questions or items left unmentioned. A few complaints arose, but within a few months, the concerns were resolved and the family of six were ready for when the inevitable would happen. Gary and Anna are still living and make a yearly review of their documents to ensure everything is up-to-date.

Which scenario would you prefer? If you are like most people, you prefer scenario 2. So would I, however, my parents were Richard and Sue (different names to protect the innocent) and I was the eldest child. It’s a hard situation to experience yet definitely opens your eyes to seeking a better solution.

Carla is one such solution. She had worked in healthcare and senior living services during her 45-year career. “I’ve seen plenty of people die and was deeply troubled by how many left life with their final wishes being unmet or even known.”

According to The Conversation Project National Survey (2018), approximately 30 percent of Americans have advanced directive documents in place. Having witnessed the lack of this vital document throughout her career, and inspired by this NPR story, Carla made the decision to help change those statistics. Her process began with taking courses through Respecting Choices, an organization dedicated to person-centered decision making, to become certified in Advance Care Planning. During this time, she networked and met with people in the local healthcare, senior living providers, local churches, hospice, and related organizations. Through recommendations and encouragement, Carla built the website, Meaningful Life and joined the Board of Directors for Gateway End of Life Coalition in 2019.

The importance of End-of-Life Conversations

With the Meaningful Life website in place, the first obstacle Carla wished to overcome was to inform people on the importance of the end-of-life conversation. “Lives can change,” states Carla. “Just like that.”

• A fall (as in the case of my father).
• A car accident.
• An act of violence.
• A sudden illness or a new diagnosis.

Yet, people don’t want to think about the what-ifs – for themselves or for those they love. As a natural part of life, however, injury, illness, and death need to be discussed to ensure all phases and what-ifs are planned for and managed. Unfortunately, culture, religion, personal fears, or superstitions can easily influence an individual’s willingness to openly discuss the topic or express their desires.

If something does happen and you are unable to speak on your own behalf, will a friend or family member be able to? Will that person be willing and able to withstand arguments and conflict from other family members? Will he or she be willing to fulfill your desires even if in disagreement about them?

For these reasons – and unknowns – it is critical to make the tough decisions when we are in top health, not when we are incapacitated or unable to speak for ourselves. Similarly, our best decisions occur when we have no health-related stressors influencing our choices or decisions. The goal is to make sure everyone knows your final wishes and to get it in writing; it’s hard to fight what is in writing!

What are the benefits of advanced directives?

Rather than leave the tough decisions to others, put yourself in control by stating your desires now! This is a process that involves key people and organizations in your life. Naturally, we first consider our family and friends in this conversation. However, remember to include your financial advisor, estate attorney, clergy, medical professionals (those you have now plus those you may have in the future), and other professionals. You are not inviting them to help you make decisions or asking them your opinion; you are informing them on your decisions!

• Having your wishes established gives healthcare professionals guidelines to your medical care and how to act on your behalf.
• Your healthcare directive enables your healthcare team to act as your advocate. (Make sure your healthcare providers all have a copy AND they read it!)
• Your health directives help reduce healthcare costs by avoiding intervention or treatments you do not want.
• There will be no question as to what treatments you wish at any stage of life.
• Having these documents established before they are needed eliminates family arguments.

When is the best time to create an advance directive?

In addition to bringing up the “death talk”, the next question often is when should the healthcare directive be created? The best choice is as soon as a child becomes an adult—in the United States, this is age 18. Up to this age, a child is under the care and supervision of a parent. Upon reaching their 18^th birthday, this new adult can make their own decisions and should be given the opportunity to do so. Otherwise, any age is ideal and it is never too late to get your wishes established.

What to include in your advanced directive?

For some, this can be as simple as, “I don’t want any lifesaving measures.” To ensure minimal confusion or possible dispute among family members, it is helpful to go into deeper detail. Visit https://1life1decision1story.com/resources/ for information to help you create specifics within your own document.

Learn about potential medical treatments to determine if these are what you do or don’t want.

This is the opportunity to choose a healthcare advocate who is willing to carry out your wishes. This person should understand your goals and values and be someone you deeply trust and must be legal adult age.

You may also wish to utilize this time to create final messages to loved ones. Many years may pass before one dies, but these messages can build over time to leave a final thought or other important memory for family, friends, and individuals. Visit https://1life1decision1story.com/capture-your-moments/ to view an example of what this may look like or download Carla’s Capture Your Moments Interview Guide.

Lastly, yet just as important, it is recommended to review and update these documents every five years.

Advanced directive recommendations.

Because of the complexity of the process and the emotions involved, Carla offers these services at no charge. “There is no reason someone can’t afford to get their advanced directive established,” says Carla. Her services do not deal with or manage the financial components of a person’s estate, but she helps prepare the legal documents and directs healthcare end-of-life choices.

To get started, Carla recommends a three-legged approach to building an advanced directive:

• Learn about advanced care planning.
• Create an inventory of what is important to you; include thoughts, fears, and requests.
• Share with others.

When this document is generated with a healthy person, the process can be completed over time with reflection and conversations, or quickly if you know what your wishes are. If a chronic or terminal illness is at hand, the recommendation is to complete this document sooner rather than later. Whatever your health status, your fears, or level of urgency, Carla offers a compassionate, guiding hand throughout the process and can be reached through her website or by email.

Have the courage to start the conversation and lead the way. Then encourage your loved ones to do the same.

Love them in health; support them in sickness.

To listen in on my personal interview with Carla, visit Carla Baum and Advance Directives to get in depth with more details about advanced directives.

Kristen

Image by Sabine van Erp from Pixabay