Planning a Graceful Exit

Thinking about and talking about end of life issues is seldom a pleasant task. We put so much planning into every other aspect of life, do we really want to leave those final decisions to chance? Or do we want to put the burden of guessing at our wishes on our loved ones?

We may hope that we can have a say in the choices made at the end of our lives, but in reality, only 1 out of 4 of us will be able to verbalize our wishes when the time comes. Advance Directives give us the chance to let our wishes be known and to name those we want to speak on our behalf when we are unable to do so.

I have put together information on this subject on our website at http://www.christchurchcharlotte.org/ministries/congregational-care/resources/deciding-for-yourself/. Here you will find information on the two Advance Directives: Living Will and Healthcare Power of Attorney, as well as two Physician’s Orders: Do Not Resuscitate (DNR) and Medical Orders for Scope of Treatment (MOST). While Advance Directives should be filled out for anyone over the age of 18, the Physician’s Orders are used in the case of terminal illness or for the elderly. Also on the website are some resources for starting these vital, but sometimes awkward conversations.

I also have copies available of the Hospice & Palliative Care Charlotte Region Booklet Isn’t It Time We Talk? A guide to Advance Care Planning, which is appropriate for any stage of life. Just stop by my office to pick one up.

Some of my own experiences as a nurse have led me to have strong feelings about having these completed documents and having your loved ones aware of them. Here are some examples of reasons I have heard not to have these, and difficult situations I have encountered:

• I’ve heard people say, “I’ve had the same doctor for 30 years. He knows my wishes.” That is all well and good, but if you have been in the hospital lately you realize you probably will not be seen by your primary doctor, but by a “hospitalist” who has no idea about your wishes. You may also be seen by a specialist, and he or she may not be the one you have seen in their office in the past, but whoever is on call.
• “My spouse and I have had these discussions and know what we want.” You and your spouse could also be in an accident together and therefore unable to speak on the other’s behalf. It then falls to your next of kin, which leads me to my next point.
• If you have more than one child and you are not married (or your spouse is unable to speak for you), all your children must agree on decisions to be made. That includes Bob in California, and Sue in Taiwan. I have seen important decisions delayed because one person was not able to be contacted. If there are no children and parents are not living, then it falls to siblings…even the one who has been estranged from the family for years. Having a Healthcare Power of Attorney named (along with an alternate) is vital in these situations.

While we cannot make decisions about every possible scenario at end of life, we can make our general wishes known at the very least. Along with funeral planning, this could be a wonderful gift to leave our loved ones at an extremely difficult time.

Please contact me if you have any questions or need any assistance with any of this information.