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The Most Uncomfortable Holiday Dinner Ever: Talking About Advance Directives

The whole family is in town. You’ve managed to get everyone seated comfortably, cooked enough food for a small army, and hand out presents.

So, no better time to have a serious and possibly somber family talk, right?

The holidays are all about good cheer, but they’re also when you have everyone together in one place. This means that even if it’s uncomfortable, and seems to bring down the mood a little bit, it might be a good time to have some difficult conversations.

End-of-life care is one of these necessary conversations. Advance directives — legal document that explains how you want medical decisions to be made at the end of your life — may not seem like the perfect holiday dinner topic. However, it’s an important topic to discuss when your family is all together.

Here’s what you should know about advance directives — and how to approach a conversation about them with your loved ones.

Deciding on End-of-Life Care for Yourself

An advance directive allows you to maintain control of your medical care decisions by sharing your end-of-life care wishes with your loved ones. This can ease your anxiety about what may happen if you are unable to communicate your needs because of a serious, life-threatening illness or injury.

These can be very difficult decisions. It may help to talk to your physicians to ensure you understand any care you are receiving or may need to receive in the future, what the benefits and side effects of specific types of care may be, and what happens if you decide to stop a particular treatment.

Once you decide on the medical care you’d like to receive, should you ever be in a situation where you need end-of-life care but are no longer able to communicate, inform your family so they can honor your decisions.

Understanding an Advance Directive

What exactly goes into an advance directive? There are two main components: a living will and a health care proxy.

  1. A living will lets your loved ones know what types of care — called end-of-life care — you want if you have cannot make medical decisions due to loss of consciousness. This might include things like how long you want to be on dialysis, breathing machines, or feeding tubes. It might also include plans for resuscitation if your breathing or heartbeat stops. And finally, it can let your loved ones know if you’d like to be an organ or tissue donor.
  2. A health care proxy, also known as a durable power of attorney for health care, is someone you appoint to make medical decisions on your behalf if you are unable to do so yourself.

To create an advance directive, you’ll need to fill out a legal document called an advance health care directive. Each state has its own specific form, which you can find on your state’s Department of Health website.

While you don’t need a lawyer to create an advance health care directive, having one can help you through the process.

The legal requirements for this document — such as the need for a witness and who needs to sign the forms — differ from state to state. Some states have registries where you can store them, but you can use a private law firm, too. Be sure to familiarize yourself with your state’s rules about advance directives.

Letting Your Loved Ones Know

Try to make the time and place for the conversation as comfortable as possible for you and your family. You may choose to talk over dinner, during a family meeting, or with individual people one at a time. You can also talk to a few family members and allow them to relay your message to others.

During this conversation, let your family know who you have chosen as your health care proxy. It’s important that everyone know so that they are confident that someone will know exactly what you want and will be able to lead the family in honoring your wishes.

Also, take your proxy aside to explain their role and let them know why you chose them. If they do not want that responsibility, or you cannot find someone that you would want to have that responsibility, don’t worry. You can still have an advance directive without choosing a proxy.

Making End-of-Life Care Decisions for a Loved One

The end-of-life conversation doesn’t just have to be about you. Others in the family may decide that they want to make plans, too.

If a loved one asks you to be their proxy, make sure that you’re comfortable taking on that role and that you understand their desires.

It can be difficult if you wouldn’t choose the same thing, but it’s important to consider your loved one’s wishes first and foremost. You were chosen to make these decisions because they trusted you to honor their values. Talk to their medical providers, review the goals of your loved one’s care, and weigh the benefits and burdens of treatments before making any decisions.

Not sure where to start in creating an advance directive? Call (785) 270-4440 to set up an appointment with a Stormont Vail primary care provider.

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