Making Your Last Wishes Known

As the very public and tragic battle surrounding Terri Schiavo's life has played out in the national media, many of us have undoubtedly been asking ourselves a troubling question: "If I were in her position, what would I want?" And, perhaps even more importantly, would anyone know what I want?

We need to start asking these questions out loud, in conversations with our husbands and wives, adult children, elderly parents, caregivers, friends and loved ones of all kinds. Indeed, if there is any good to come out of the firestorm over Teri Schiavo's case, let it be increased awareness of the need for and use of "advance directives" -- documents that spell out in writing how you wish to spend your final days.

Those of us involved in hospice care are experienced in dealing with these issues. We see that people who have prepared advance directives are able to exert greater control over their care and circumstances even as the process of disease or injury reduce their ability to communicate. Meanwhile, family members are spared the emotional turmoil, doubt and guilt that come with trying to guess what their loved one's wishes might have been. In that sense, preparing advance directives is one of the most unselfish acts you can perform for the people you love.

Despite the obvious benefits, it's estimated that less than 20 percent of Americans have prepared advance directives. Why have so few undertaken this important step? There is no simple answer, but ours is a death-denying society, and broaching this subject is difficult for most of us. Hospice of Kitsap County has resources that can help you start thinking and talking about this issue. Here are some suggestions:

Draw up a living will with written instructions for what you want done in specific end-of-life circumstances. At Hospice we use Five Wishes, a helpful template used to create a personalized living will. For a complementary copy of Five Wishes, please call Hospice of Kitsap County.
You should also have a durable power of attorney (DPOA) in place that authorizes the person of your choosing to make decisions if you are unable to do so. Once you decide on your end-of-life wishes, don’t keep the document in a bank vault or shoebox. Share it with those you love and those who are likely to be in a position to influence the health care decisions if and when you become unable to directly communicate your wishes.
Discuss your end-of-life wishes with your family and loved ones now -- before a crisis hits. While these are difficult conversations to start, often a milestone or transition in life can provide an opportunity.
In addition to communicating your own preferences, you may need to take the initiative with a family member or loved one who has not shared their end-of-life wishes. "Ask permission" to hold this conversation by saying something like: "If you ever got sick, I would be afraid of not knowing the kind of care you would like. Could we talk about this now?" If your loved one refuses to discuss it, try again at another time.
While the Schiavo case focuses our attention specifically on the issue of extending life through artificial means, other aspects of end-of-life care should also be addressed. If terminally ill, would you prefer to be cared for at home or in some other setting? What are your preferences for spiritual support during such a time? Tackling these issues early can ensure that your wishes will be understood and followed when the time comes.
The circumstances surrounding Terri Schiavo's case -- a young woman suddenly incapacitated in the prime of life -- should remind us that it's never too early to begin talking about how we would want to be treated when we can no longer speak for ourselves.

"What would they have wanted?" Don't let that question go unanswered among your loved ones. Talk about your wishes, ask others about theirs and complete your advance directives. It is one of the best ways to ensure that you and your loved ones meet one of life's most difficult times with grace, dignity, comfort and compassion.

Hospice of Kitsap County has been helping families face end-of-life care challenges since 1979. If you or a loved one would like more information about end-of-life concerns, please call us (360) 698-4611.