Welcome Wisdom

The Gift of a Plan

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

2023 is drawing to a close and our year-long discussion about the challenges of aging concludes with the topic of End of Life planning. As the season of gift-giving approaches, we emphasize that having a plan and documenting end of life wishes is truly a gift to those we love. In doing so, we relieve others of making choices for us with uncertainty. Aging Life Care Professionals often have the privilege of assisting older adults, and those who love them, as they journey through the season leading up to the end of life. We understand and promote the necessity of planning for this last stage of life.

Conversations about death and dying, and the kind of care a person desires, are not easy or comfortable exchanges. We live in a culture where the death experience has become somewhat removed, often happening in hospitals. Death is sometimes viewed as something to beat and relegated to a failure or something negative instead of a natural part of the human experience. It can be very difficult for a family member to bring up the subject of death to their loved one. However, studies show that many are relieved to share their thoughts, feelings, and wishes about their death and just need to know someone else wants to hear them. We can’t stress enough the importance of having those conversations early– before the onset of health challenges that may preclude the ability to communicate one’s preferences.

Care managers reinforce the importance of documenting end of life decisions with an advance health care directive (AHCD). This document provides instructions for health care and appoints an agent or power of attorney for health care. An AHCD can specify preferences for life-sustaining treatment like CPR, feeding tubes, breathing machines, pain medication, and organ donation. Many individuals have such documents as part of their trust planning. We advise clients to review those documents and ensure they are still relevant and represent their end of life wishes. We also stress the importance of determining if their designated agent is still able to fulfill that role if needed and ensure they have named an alternate agent in the event the primary person is unavailable. Also critical, is providing a copy of documents to anyone who is named as an agent– so they may speak for and make decisions on behalf of the ill or dying person.

An Aging Life Care Professional is equipped to help clients distinguish between different types of advance health care directives that are available and determine when each is appropriate. For instance, the POLST (Physician Order for Life-Sustaining Treatment) is an increasingly used form to communicate health care preferences. Care managers are a valuable source of information as older adults ponder their preferences for care at the end of life. We encourage discussion with physicians and help inform conversations with insight gained from interaction with the client, helping them understand care choices considering their individual circumstances. An Aging Life Care Manager is familiar with and sensitive to the needs of those with dementia and also solo agers and how their needs impact end-of-life planning and care. Care managers assist clients with understanding resources like palliative care and hospice and other services that provide support at the end of life.

Understanding the services that are available is an important part of early conversations and decision-making about end of life care. Developing a network of support and collaborating with professionals like an Aging Life Care manager can assist the planning process so you can have the conversation, complete the documents, and provide the gift of reassurance to others.