If you had a terminal illness, what kind of care would you want to receive? Who would you want caring for you?
These questions might have crossed your mind, at least briefly, but dwelling on them might make you uncomfortable. It's understandable: Thinking about these things dredges up feelings of sadness and fear.
Having an end-of-life care plan is the best way to ensure that you'll be able to face your final moments with peace and dignity and in a way that honors your values. The best time to start this process is now — when you're still healthy and still have the presence of mind to make sound decisions about your care.
Here's how you can work up your own end-of-life care plan or help a loved one make theirs.
Understanding End-of-Life Care
End-of-life care is also known as hospice care; you might have had a family member or friend go through this experience, which typically begins when someone with a terminal illness is expected to die within six months. The goal of care at this stage is to provide comfort to dying patients and support to their families. Medicare, Veterans Affairs and private insurance companies cover hospice care.
Hospice care can be administered in the patient's home or at a hospice center, hospital or nursing home. The team attending to the patient's needs usually includes specially trained health care providers and a primary caregiver who monitors the patient at home or who's in constant contact with hospice facility staff.
Should you ever need end-of-life care, an end-of-life care plan will direct how your team addresses your physical, emotional and spiritual needs.
Talking About End-of-Life Decisions
Maybe you already have strong opinions about what should and shouldn't happen if you become gravely ill. Maybe you're not sure yet how you feel about the care decisions you and your loved ones will face during such a time. If you're still trying to discern your own wishes, jot down some of your initial thoughts and concerns and explore them further. Research possible medical scenarios and the options that would be available in each case. Consider how your personal views, spiritual beliefs or family traditions might guide your choices.
Once you've determined what you want, talk to your family. End-of-life care isn't easy to talk about, but knowing your desires can help you find a way to confidently share them with others. A recent health scare, a family funeral or even a TV story could be a good conversation starter. Tell your loved ones that you've thought a lot about what you would want in that situation, then go from there.
Creating an Advance Directive
No matter how carefully you explain your end-of-life care wishes to your loved ones and your health care providers, the emotional stress of dealing with a health crisis could interfere with those wishes when it's time to carry them out. Formally documenting your end-of-life care plan by completing a legal document called an advance directive helps ensure that your wishes are carried out.
An advance directive usually consists of a living will and a medical power of attorney. A living will, also called an instruction directive, lists the medical treatments you want to receive or refuse; it only goes into effect if you're unable to make those choices for yourself. A medical power of attorney directive designates the person you want to make health care decisions on your behalf when you cannot.
Each state uses a specific form for its advance directives. The National Hospice and Palliative Care Organization has a page where you can download the advance directive form for your state for free.
By discussing and formalizing an end-of-life care plan, you can be confident and at peace knowing that your loved ones and health care providers will understand and honor your wishes.