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  • Senior Care Options

Part 5: Advance Directives: A Step-by-Step Guide

  • Dec 3rd, 2020
  • Cathy Gasiorowicz
  • 6-min Read

The conversation around Advance Directives may have gotten louder since the start of the pandemic, but Lifespark has always been passionate about helping you stay in control and more independent throughout your life journey—and part of that is deciding what kind of medical care you would want in the event that you couldn’t speak for yourself. “Lifespark’s approach to life planning is based on our ‘seven essential elements of wellbeing’ which fosters conversations about values, wishes, and goals,” said  Hilary Frank, Lifespark Director of CORE Operations for LEADS. “Those discussions allow our clients to think about what they want when they are nearing the end of life.”

In the first four blogs of this Advance Directives series, we covered the “What, Who, When, and Why” of Advance Directives. In this blog, we’ll focus on the “How” with a step-by-step guide and some helpful links.

Universally relevant and empowering

It’s important to remember that Advance Directives aren’t just for people in hospice or facing a terminal illness—they’re for everyone, because severe illness and serious accidents can happen to people at any age. “The act of writing and sharing your medical and end-of-life wishes puts you at the helm of your life in a really empowering way,” said Hilary. “It also greatly eases the burden on family members. Following your written instructions help them trust their ability to make the right decisions.” Wherever you are in your life journey, there’s no time like the present to begin planning for the future.

Let’s get started.

Step 1: Think about your goals

The first step is to spend some time thinking about your goals and values as they relate to your health and quality of life. Ask yourself questions like:

“What does a good day look like?”

“What is a good death?”

“What are my most important goals if my health condition gets worse?

“How much medical treatment am I willing to have in exchange for more time?

“If I’m dying, do I want to be pain-free, even if it makes me sleepy?”

“Who do I want to have near me at the end of my life?”

The Conversation Project offers an excellent workbook that can help clarify what matters most to you. The workbook doesn’t replace the Advance Directive, but it’s a useful tool for identifying the kind of care you want and sharing that with loved ones.

Step 2: Start the conversation

Not all families are equally comfortable talking about death and dying. One of the suggestions in the blog, ‘Easy Ways to Start Hard Conversations,’ is to have an opener. “With the pandemic on everyone’s mind these days, COVID is actually a practical way to start a conversation about medical and end-of-life wishes,” said Laurie Endris, MSW, LGSW, Hospice Social Worker at Lifespark.

“Often, the family won’t bring it up because they’re worried how their loved one will react. Sometimes, the older adult will avoid mentioning ‘the elephant in the room’ because they don’t want to upset their family members.” To overcome fears on both sides, Laurie frames the discussion as a way of taking the strain off those we love. “We need to normalize this conversation so we can understand what our loved ones want—both in life and in death,” she said.

Step 3: Choose a healthcare proxy

Your healthcare proxy, also called medical power of attorney or healthcare agent, is a person you appoint to make healthcare decisions for you in the event you are unable to speak for yourself. You can also appoint co-agents or have a primary and a secondary proxy.

Often spouses or partners will act as each other’s proxy, but that may not always be the ideal choice. “As people age, it may make sense to appoint an adult daughter or son, or a close family friend as your proxy,” said Hilary. “What’s important is to choose someone who will be able to advocate for your wishes and goals.”

Step 4: Create your Advance Directive

Once you’re ready to create your Advance Directive, you can use one of the forms from Honoring Choices Minnesota, Mayo Clinic, Minnesota Attorney General, or your healthcare provider’s website.

Most forms are divided into four main sections:

Section 1: Name and contact information of your healthcare proxy, and an alternate, if you wish.

Section 2: Your healthcare instructions, including treatment choices and organ donation.

Section 3: Hopes and wishes for how you would like to die and any other instructions.

Section 4: Your signature and the signature of a notary public or two adult witnesses who are not your healthcare proxy.

Step 5: Share your Advance Directive

After you complete your Advance Directive, there are a few more items to take care of:

  • Give copies to your healthcare proxy, and to your alternative, if you have one.
  • Share your wishes and the name of your proxy with other close friends and family who might be involved.
  • Give copies to your primary care physician and other important providers and make sure they understand your wishes.
  • Store a copy at home where it can be easily found and accessed in case you have to be hospitalized.
  • Review your Advance Directive at your annual wellness exam, if your healthcare proxy can no longer fill that role, or whenever you experience one of the Five D’s:
    • Decade—when you start each new decade of your life
    • Death—when you experience the death of a loved one
    • Divorce—when you go through a divorce or other major family change
    • Diagnosis—when you are diagnosed with a serious health condition
    • Decline—when you experience a significant decline in your health, especially if you’re unable to live on your own

“Following a loved one’s wishes isn’t always easy,” said Laurie. “Even when you know you did the right thing, you might still experience something called ‘bereavement regret,’ which is a normal part of grieving.” She added that for some families, dedicating a bench, a tree, or a plaque in the loved one’s name can be immensely healing.

If you would like to learn more about Lifespark resources, including helping to facilitate difficult conversations, schedule a free consultation, contact us at 952-345-0919 or email ShineOn@Lifespark.com.

To learn more about Advance Directives, click the links below for previous blogs in this series

Part 1: Advance Directives—The Gift of a Lifetime

Part 2: Advance Directives—Easy Ways to Start Hard Conversations

Part 3: Advance Directives—Myths and Truths

Part 4: Advance Directives—Personal Perspectives

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