Advanced Care Planning

Often, when I mention the topic of Advance Care Planning and health directives, the eyes of the person I’m speaking with glaze over and instant fortress walls are built. Most people think that advance directives are necessary only for the oldest of older adults and feel uncompelled to take any steps to prepare one for themselves. Yet, there are so many reasons to complete one, even as a young adult. I recall completing mine when my husband and I did our estate planning years ago when our children were born.   Yet then, even as a health care professional, I had very little understanding of the impact of not only completing the legal documentation, but in having these difficult conversations with the important people in my life.

Why is the topic of Advance Care Planning one that is largely avoided? Most people do not think that they need to worry about the future and they assume that they will be able to make their own decisions during a health crises. However this often is not the case. Most people will not be able to make their own decisions because they may be unconscious or confused.   Families are then left to make decisions for their loved ones during very stressful situations. Yet they enter this role with little preparation and less confidence that they are doing the right thing.   Everyone knows that they should have important conversations about their wishes for their goals for care whether in a health crises or at the end of life, but people simply do not. Another reason for avoiding the topic is that most people do not know how to have the conversations. Even if an older adult is motivated to open the discussion with their children, they may face resistance. “I don’t want to talk about this. You’re fine!” is a common response from adult children. Again, fortress walls are built. Unfortunately, those walls can not prevent the unexpected health event and when it comes, more peace of mind is achieved for entire families by being prepared.

In my care management practice, I work with each of my families to ensure that they not only have the appropriate documentation, but that families have rich and meaningful conversations about the values and wishes of their loved ones. We also discuss scenarios so that the designated spokesperson can be prepared when they are called to step in as decision maker.   There is no perfect way to prepare for every situation. But when the designated spokesperson and the family are “trained” in their role, everyone has peace of mind that they are honoring their loved at a time when it matters the most.

As a volunteer for the Orange County Aging Services Collaborative, I also provide community presentations on Advance Care Planning. “Advance Care Planning, Important Choices for Living and Dying” is a one hour presentation developed by the California Coalition for Compassionate Care and funded by the Alzheimer’s Association, St. Joseph Health, Orange County Aging Services Collaborative, SCAN Health Plan, and the California Healthcare Foundation. This free seminar teaches participants how to have these conversations and provides resources for preparing legal documentation of healthcare treatment wishes. I would be happy to speak on this topic for your church, men’s or women’s group, school or neighborhood.   Please feel free to contact me to arrange a seminar or to assess the advance care planning needs in your family.