Advice Center

After a period of illness, it’s only natural to want to reclaim control over how our final days, or even weeks, are lived. Even without a diagnosed illness, we want to know we can make choices over the critical medical care we will receive.

That’s why people create advance directives. Advance directives are responsible for ensuring our wishes for end-of-life care are respected.

What we want and what our loved ones want for us can be at odds. That’s why having directives in place - with a communications strategy to accompany them - sets you up for the best chance of having your wishes for end-of-life care fulfilled.

What are advance directives?

Advance directives are official documents outlining your wishes and ensure your personal values are respected when it comes to healthcare decisions. They are a way of having control, even when t you are no longer able to competently make decisions for yourself.

For these directives to be valid, you need to make them while you are still considered of sound mind and body - meaning you’re still able to make decisions on your own.

Some common advance directives are:

• Palliative care
• Do not resuscitate (DNR) orders
• Refusal or withdrawal of treatment
• Refusal of food and drink
• Palliative sedation to ensure comfort
• Organ donation

How to communicate advance directives to your doctor

If you have any type of advance directive, ensure these documents are readily available to your medical team. They should be held in your medical file for future reference.

To ensure your medical team follows these advance directives, it’s best to encourage a loved one to act as your advocate. Give copies to a trusted person, making sure they are given to the person acting as your healthcare proxy or power of attorney.

If someone is going to act on your behalf should you lose your ability to make decisions, introduce this person to members of your medical team so they can better communicate when the time comes.

How to communicate advance directives to your loved ones

It’s important to have these conversations early.

If you’re suffering from a terminal condition or your health takes a turn for the worse, outline your advance directives and communicate them clearly to your closest friends and family - those who will assume responsibility for your care. It’s especially important to share this information with the person who will be designated your healthcare proxy or power of attorney.

It can be difficult for those closest to us to picture a time where we may not be able to make our own decisions, or our health may be drastically failing.

That’s why it’s important to have these conversations while you’re able to do so. You’re able to share your perspective about why these directives are important to you and the personal significance of things like a DNR order or your wish to have your organs donated.

It may be useful to bring close friends and family members together in a comfortable gathering, maybe doing something together you all love.

Outlining your directives on paper and ensuring multiple copies are available, with backup copies online, is another way to solidify these wishes in the minds of your loved ones.

Above all, make sure your loved ones know how important these are to you. Bee assertive when sharing your wishes for your life and your body. You want those wishes respected. Make it clear that is the best way to honor you.

What to do when family members disagree

Often, family members may disagree with your advance directives because they mean shortening the length of your life.

In the case of terminal or chronic illness, you can opt to create advance directives that prevent life-extending treatments. After feeling the pain of illness, you may want a more peaceful end-of-life.

This can be at odds with what your family wants. It’s only natural for them to want to spend as much time with you as possible, but not at the expense of respecting your wishes.

This is something you need to communicate upfront.

Appointing a power of attorney who has decision making power on your behalf can be a big help. This person is your most trusted advocate in the end-of-life process. They hold your decision-making power and can be trusted to follow your wishes through.

Be open and firm

Like anything, good communication is one of the best tools for success.

Communicate your wishes explicitly and firmly with your family. Transcribe those wishes into formal advance directives, passing those along to your medical team and trusted power of attorney.

Explain from the heart so your family members, even those who disagree, understand your wishes for end-of-life care. Despite their sadness, respecting your wishes will come easier when they know what you truly want.

Sources:
https://blog.ioaging.org/end-of-life/when-families-disagree-about-an-aging-loved-ones-advance-directive/