I was nearing the end of a virtual medical appointment and ready to hang up the phone when my doctor interrupted me.
“One last thing — I need you to fill out your advance directive before the next time we meet. I know that might be a lot to take in, but we recommend this to all of our patients.”
She hung up the phone, and I sat trying to process everything. I had a sinking feeling in my stomach as I reflected on the events that led to this moment. The week prior, I had a spontaneous tear in an artery in my neck. This is one of the most common causes of stroke in healthy people under the age of 40. My doctor told me I was one of the “lucky ones” and was expected to make a full recovery. Yet at 29, I was suddenly all too aware of how fragile life can be.
This wasn’t the first time I had heard about an advance directive. I knew everyone over the age of 18 should fill one out. It allows you to direct future medical care and to alleviate the potential burden on your loved ones if they are put in a position to make health decisions on your behalf. I assumed an advance directive was something that I could think about and address later. It was not a priority at the time.
Death and loss become taboo topics in a society that fears aging and end of life. I considered myself comfortable talking about death until I unexpectedly faced my own mortality. It would have been easier to plan for my end of life decisions on my own terms versus being told that I needed to do so after a traumatic health event. I wished I had been more prepared. It wasn’t something I could put off any longer, so I reached out to my healthcare provider and set aside time to fill out my advance directive.
What is an Advance Directive?
An advance directive is a legal document that allows an individual to plan for and describe their overall medical preferences and decisions for end of life care. This document guides healthcare providers if a person is no longer able to make decisions. It is often referred to as a living will. It includes topics such as decisions for life-prolonging measures (such as resuscitation or ventilators), organ or tissue donation, autopsy preferences, and palliative or hospice care. There is also the option to appoint a health care agent or health care power of attorney. Someone trusted to act on the advance directive if needed and make decisions in unforeseen circumstances.
An advance directive does not discuss financial matters or medical decisions related to mental health. The forms vary based on state laws and can be updated or terminated at any point. It is recommended that they are reviewed and updated regularly, and specifically in the case of any major life change or health event.
Many advance directives will also include a portion on personal preferences for comfort and end of life rituals. The following are examples of topics, although they may differ based on the specific form:
- Religious preferences or rituals
- Comfort needs such as sleeping positions, favorite music or scents
- Desires if nearing end of life, including who should be present if able
- Personal messages to leave friends and family if unable to communicate
Taking the time to discuss end of life plans and medical preferences seemed intimidating at first. After setting aside time to do this and discussing my wishes with my loved ones, it felt empowering. Death is guaranteed. Make it a priority, and take the time to prepare.
If you are over the age of 18, consider talking to your health care provider or an attorney about an advance directive. Then take the time to speak with your loved ones about your own personal preferences. Death is a natural part of life and something we can work to become more comfortable discussing at all ages. Taking the time to prepare now is not only to your own personal benefit but also to those who care for you.
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What a remarkably simple but powerful article. Sensitive where needed but delivering the most important advice in a person’s lifetime…the decision about their life and death.
“Truth is Incontrovertible. Malice may attack it and ignorance may deride it, but in the end, There It Is.” Winston Churchill.
The time for YOU to make YOUR wishes and desires known, about how you want to be treated when you are unable to speak for your self, is NOW. Do you really want to burden your loved ones with the terrible responsibility to decide about continuing your life, in a manner you never would have chosen for yourself?