Welcome Wisdom

Constructive Conversations: Advance Directives, Healthcare Preferences & End-of-Life Planning

by Felicia Juntunen, MA, CMC, Director of Care Management

Talking about death and end-of-life care is never easy, but it is crucial. Many people avoid this topic, making it difficult to initiate conversations with family members. However, planning ahead and communicating your healthcare preferences can bring peace of mind to everyone involved.

The Conversation Project, a national initiative aimed at encouraging these important discussions, highlights just how necessary these conversations are. A 2018 survey revealed that:

• 97% of respondents agree that it is important to document end-of-life wishes.
• Only 37% have actually created formal documents.
• While 32% acknowledge the importance of talking about end-of-life care, only 2% have had the conversation with their loved ones.

Although the topic of death is often avoided, it is an inevitable part of life, and preparing for it can prevent unnecessary hardship.

 

The Role of Care Managers in End-of-Life Planning

Care managers play a key role in helping families navigate aging and end-of-life decisions. They guide individuals through the process of making informed choices about their healthcare and ensure their wishes are communicated clearly.

Some essential points Care Managers emphasize include:

• Early Conversations: Having discussions early in the aging journey can minimize confusion and stress later on.
• Advance Directives: These documents outline a person’s healthcare preferences and identify who will speak on their behalf if they are unable to do so.
• Quality of Life: What matters most to the individual, and what are their wishes regarding life-sustaining treatments? These are central to the planning process.

Planning and documenting your preferences help alleviate the burden on family members, ensuring that your wishes are respected during a difficult time.

 

Kent’s Story: The Importance of Preparing in Advance

Kent*, an Elder Care Management client, lived with anxiety and mild cognitive impairment. These conditions made it challenging for his daughter, Liz, to assist him with updating his healthcare directive. Liz reached out to Kent’s care manager for help, who recommended the following steps:

• Timing: Choose the best time of day for Kent, when he is most alert and able to focus.
• Location: Ensure the environment is calm and free of distractions.
• Preparation: Liz was encouraged to avoid distractions and create a quiet, comfortable space for the conversation.

Kent’s situation highlights a crucial point: it’s essential to complete healthcare directives while a person still has the mental capacity to do so. Once dementia or a terminal illness is diagnosed, it becomes much harder to make these decisions.

 

Six Steps for Advance Care Planning

The Conversation Project recommends the following steps to help individuals and families navigate the process of advance care planning:

1. Evaluate Quality of Life: What do you want your quality of life to look like in the event of a serious illness?
2. Have a Conversation: Talk with your loved ones about your preferences and expectations.
3. Identify a Decision-Maker: Choose a trusted person who can make healthcare decisions on your behalf.
4. Consult Your Healthcare Provider: Discuss your wishes with your doctor to ensure they align with medical possibilities.
5. Complete the Paperwork: Formalize your wishes through an advance healthcare directive.
6. Review and Adjust: As your health changes, revisit and adjust your preferences.

 

The Relief of Planning Ahead

Though it may feel uncomfortable to talk about end-of-life planning, care managers report that families often experience significant relief after these discussions are had. Being prepared and clear about your healthcare preferences allows everyone to focus on what truly matters during difficult times—ensuring that your wishes are respected and minimizing stress for your loved ones.

*names have been changed to protect client identities