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Planning Ahead for End-of-Life Care Decisions

In our last blog post, we shared some couples-oriented guidance for creating aging plans. As we noted, creating an aging plan takes some bravery and a lot of thought, and being part of a couple can add a layer of complexity.

Now let’s zoom in on the elements of an aging plan that each of us must tackle as individuals: your healthcare proxy and your personal directive/living will. These documents – which must be signed and witnessed – outline the treatment and care you want to receive should you become unable to communicate. (The names of these documents vary from state to state – here we’re focusing on what’s needed in Massachusetts.)

You can approach this project by focusing on three key components: the concept of patient choice, the documents you’ll need, and communication with your loved ones.

Patient choice

When it comes to healthcare, the patient is the decision maker. This means that as long as you are able, you should ask questions and understand your diagnosis and all potential treatment options. If a time comes when you cannot advocate for yourself, your healthcare providers will work with the person you name in your healthcare proxy, which we discuss in the next section. Together, your proxy and your healthcare providers will implement your care plan according to your personal directive.

The documents

This is the core of your planning, and it’s important to use documents specific to your state. Massachusetts residents have a great resource called Honoring Choices Massachusetts, which describes itself as “a consumer oriented nonprofit organization.” Their website offers information, webinars, and free downloadable PDFs of these documents.

• With your healthcare proxy, you name a trusted person (“proxy” refers to both the document and the person) who will communicate your healthcare wishes on your behalf if you become unable to do so. Besides discussing this role thoroughly with your proxy, you will want to review and discuss your personal directive with them and be sure they have copies of both documents.
• Your personal directive/living will outlines your personal beliefs about care and your instructions about life-sustaining treatment such as CPR or nutrition and hydration. In Massachusetts, if you have a serious advancing illness, you may also wish to complete a MOLST form (medical orders for life-sustaining treatment). Ask your doctor to explain how it works and whether adding a MOLST form as part your advance planning seems appropriate.

Remember, you can use your advance directive, including a MOLST form, to say both what you do and do not want in the way of care.

Discuss your wishes with your family

Taking the time to discuss your end-of-life wishes and plans – no matter what your age or health – will go a long way toward ensuring peace of mind for you and your loved ones.

It can be easy to avoid this topic. No one likes to talk about a parent or other loved one potentially being unconscious, on life support, or otherwise unable to state their wishes. But the more you plan, the more comfortable you’ll become with discussing your wishes. What’s more, doing so will ensure your loved ones or friends are not burdened with trying to guess what you might want.

At LifeCare Advocates, we offer consultation services that will help you feel empowered about your healthcare and life choices. Our Care Managers are trained in assisting our clients plan for end of life and empowering them to take control of this decision-making process. We have also received training as a community partner of Honoring Choices Massachusetts.