Why talk about death?
During a visit to my primary care physician in my early 20’s, my doctor asked me if I would like to complete an advanced directive form. As a healthy young person, the questions on the form were foreign. I had never thought about planning for my end-of-life. What did I want to happen to me should I become unable to breathe on my own? Did I want to be fed artificially? If I became incapacitated, who should make decisions for me? I thought little of the form at the time. I had thought very little of my own death! The only other time I had ever made a decision regarding my own death was when I decided to be an organ donor at age 16.
Now, after working with individuals and their families in facing end-of-life decisions, I know how important it is to reflect on these difficult questions and have discussions with your loved ones. If you do not set forth guidance in advance, and you become unable to communicate what you want and need, what would happen? Bewildered, grieving family members are left to make the best decisions they can. Today, I look back in admiration on that primary care practice for incorporating that basic advanced directive form in their routine patient care.
The Five Wishes
A wonderful resource for beginning discussions about end-of-life decision-making is the Five Wishes, a structured series of questions offered by the non-profit organization Aging with Dignity. You can notarize the Five Wishes document and it beecomes the ruling document in the event of your incapacitation. Unfortunately, the form is not free, but you can view a watermarked version on their website. The non-watermarked version costs five dollars. There may also be local resources near you where you can get the booklet for free.
A typical advanced direction tends to focus on medical interventions whereas the Five Wishes has a much broader scope. The Five Wishes include holistic measures for comfort and quality of life. The document reflects many aspects of serious illness. For example, regarding relationships, the document gives options including: “I wish for my family and friends and caregivers to respect my wishes even if they don’t agree with them” and “I wish to be cared for with kindness and cheerfulness, not sadness.” Regarding hygiene and physical comfort: “I want lips and mouth kept moist to prevent dryness” and “I wish to have warm baths often. I wish to be kept fresh and clean at all times.” The document allows for individuals to fully set forth what comfort and dignity mean to them in the end of life.
Make your own free advanced directive
Each state has its own laws regarding advanced directives. The AARP provides free advanced directive documents tailored for each state. These standard forms include additional blank space for customizing the plan. This way you can create your own legal document tailored to capture your desires. No matter your age or health, consider reflecting on the prompts in the Five Wishes. Who would you want to make decisions for you? What does life support mean? What is most important to you for comfort? The exercise is challenging, but also supports the discovery of your own essential values that define a quality life.