Advance directives speak for you, when you can no longer make your medical decisions. These legal documents tell your family what you want to happen when you cannot communicate your wishes. In a crisis, these papers are meaningless if your family does not know about them and does not know your preferences. Many advance directives merely designate a person to decide for them, if they cannot. You must have a conversation to discuss what you want to happen in that circumstance. Effective advance directives require family communication. It is far better to include a living will and a medical power of attorney in your advanced directive. The living will states your wishes for end of life decisions and the medical power of attorney names someone to help carry out those wishes.
When you ask someone to make life-and-death decisions for you, you are asking a great deal . If you designate someone as your decision-maker in your advance directive (AD) and do not sit down and explain to them how you feel about specific medical situations, such as prolonging life if you are in a vegetative state, you are needlessly creating extreme stress for them.
It can be uncomfortable for both the parent and the adult child to talk about “pulling the plug,” yet it is far more uncomfortable later on if you do not. The advance directives conversation involves more issues than just whether to use or continue life support. People think these documents are about dying, and it's awkward to talk about death. In reality, advance directives are about living – how you want to live the final segment of your life.
Although studies show that about 70 percent of people would prefer to die at home, only about 30 percent do. If people talked about where they wanted to spend their last days, their families could honor these preferences. ADs can also cover hospice care issues, such as using palliative medications to keep the person comfortable and pain-free. In a family with a diversity of religious observances, a conversation may be needed to make sure the person receives the desired rituals, such as last rites, in the manner she wants.
There are three reasons to have a conversation with your loved ones about your or their advance directive:
- Having the AD conversation will spare your loved one from having to make agonizing decisions in a crisis, if they already know your wishes. It can give them some peace of mind to know that they honored what you wanted. Knowing your preferences can take a massive burden off of their shoulders.
- Talking with your entire family – not just the one person designated in your AD – can prevent toxic family drama. If, for example, you select one of your daughters in your AD and do not talk with her and your other children about your wishes, you may be putting your daughter in an awkward spot with her siblings. Your other children may get angry at her, if they disagree with her decisions. If they all know your wishes, you can avoid this scenario.
- Although it's frightening to give up control, when you create an AD and talk with your family about your wishes, you are seizing control. You are deciding for yourself if you cannot do so in the future. Without an advance directive and a talk with your family, you are at the mercy of what other people will decide for you.
Since the laws are different in every state, talk with an elder law attorney in your area.
Billings Gazette. “Advance Directives set course for end of life decisions.” (accessed October 5, 2017) http://billingsgazette.com/news/local/have-you-had-the-conversation/article_43737b6b-a0c3-50ac-b723-5947aeb15a01.html
Care.com. “3 Reasons to Have the Advance Directives Conversation.” (accessed October 5, 2017) https://www.care.com/c/stories/7668/3-reasons-to-have-the-advance-directives-conv/