Advance Directives - Talking to the Right People About Your Decisions

Step Three in the Process of Expressing Your End-of-Life Wishes

Now that you've made your decisions about your end-of-life care, and you've put them into writing to protect your wishes, and protect those who will ensure they are carried out, you'll want to advise those who might be at your bedside at the end of life about the decisions you have made. Those people may be your:

• proxy (and secondary proxy)
• spouse or partner
• children
• parents
• siblings
• healthcare providers
• attorney
• pastor, priest, rabbi or spiritual advisor
• caregivers not included in the list above
• close friends who may be at your bedside

Some people have already accomplished this step while as those decisions were being made, and the documents prepared. For example, asking permission of a healthcare proxy before designating that person's name in an advance care document would mean that the proxy knows about that choice. Using an attorney to draw up the written documents (which is not required, but can be helpful) would mean the attorney has already been advised of those wishes.

When End-of-Life Conversations Are Uncomfortable

While conversations about end-of-life are a daily occurrence for healthcare professionals and attorneys, having those conversations with loved ones in your life may be unsettling, and may be rejected.

You can begin by using these conversation starters that provide resources for a segue into a conversation with your loved one.

Then, if you still need help, a number of organizations provide advice for having those conversations. Their approaches are based on the belief that one's end-of-life can be less stressful, less emotionally difficult, and less financially devastating if loved ones know what to expect ahead of time.

• The Center for Practical Bioethics provides a brochure called Caring Conversations®
  
  
• Talking With Others About End-of-Life Wishes is available from Caring Connections.
  
  
• The American Bar Association's advance care planning toolkit includes Conversation Scripts: Getting Past the Resistance

Once your decisions are made, recorded and reviewed with the important people in your life, you'll want to make sure they are stored correctly so they will be found when the time is right.

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Four Steps to Expressing Your End of Life Wishes

1. Ask the right questions and determine your answers.
2. Record those answers in the appropriate documents.
3. Discuss your decisions and your wishes with your loved ones and others who need to know.
4. File or store any paperwork or electronic files you have produced, and distribute copies to the right people.