What is end-of-life planning?

If you are terminally ill or are coming to the end of your life, talking about your wishes for your final months should be part of the process.  Nobody really wants to face the idea of planning for death.  However, when you have written down your personal preferences and wishes, it lightens the decision-making burden on your family. Planning ahead also means you receive medical care based on your own choices even if you can no longer speak for yourself.

Speaking about death

Medical advances have made us very efficient at preventing death but not quite as efficient at ensuring quality of life.  Preserving life at all costs often results in people dying in hospital beds going through unwanted procedures and treatments. As we are living longer, we need to talk about the subject of death and our rights when it comes to end-of-life care. Talking about death is not easy and we often choose to avoid the subject altogether.

The Conversation Project is an organization that helps people to talk about their wishes for end-of-life care.  Another website called Dying Matters is helping to raise awareness of dying, death and bereavement.  In an inspiring video on this site, Dr. Kate Granger talks about her experience of living with terminal cancer as well as how she has planned ahead for her future care.

If you are a taking care of elderly parents, don’t avoid the subject of death. If you have no idea about their wishes, discuss the subject openly. There is no right or wrong way to talk about it.  Sometimes we go to great lengths to avoid conversations that can actually bring relief to someone who is dying. I recently went to the funeral of the mother of a friend – she had planned her whole funeral down to the glass of sherry we all received afterwards. It was as though she was right there, thoroughly enjoying the event. Do you know your elderly parents wishes when it comes to their funerals?

End-of-life checklists

Most people, when asked, say they would like their death to be quick, painless, at home and surrounded by loved ones. However, planning for death is often ignored – as if by planning for it we hasten its coming.  Two years ago my elderly mother handed me a newsletter about living wills and said she would like to make one. I recently found the newsletter buried under a stack of other correspondence and faced the fact that I did not want to think about the death of my mother.  I realized that ignoring my mother’s wishes was only part of my reluctance. I didn’t want to face my own mortality either.

A website called Everplans  allows you to create, share and store important documents that your loved ones might need. An Advance Health Care Directive (also called a Living Will), End-of-Life Housing, Estate Planning, Funeral Planning and even an Obituary and Death Notice form part of the end-of-life checklists found on the site.

Our decisions about what happens at the end of our lives is very personal and is based on our beliefs and values.   Caring Info is another helpful website with some useful resources that may help you to start that difficult conversation. You will find the answers on this site to many of the questions you might have when trying to make your decisions.

Books to read

The following books present some interesting perspectives on end-of-life and what matters most.

I’ll Have It My Way: Taking Control of End of Life Decisions: a Book about Freedom & Peace by Hattie Bryant.
Inspired by the peaceful death her mother was almost denied, Bryant began gathering information from national experts in palliative care, geriatrics, oncology, bio-ethics, psychology, and spirituality. This books presents the case for personal responsibility in decisions that all of us must make―if they are not to be made for us.

Knocking on Heaven’s Door: A Daughter’s Journey Through Old Age and New Medicine by Katy Butler
Most of us do not wish to die with a tube down our throats but the cruel fact is, as Katy Butler reminds us, that a fifth of American deaths now take place in intensive care and at great expense.

Being Mortal: Medicine and What Matters in the End by Atul Gawande is a New York Times bestseller. Gawande is a practicing surgeon and he tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending. 

Not just a good life but a good end

Planning for death can have a positive impact not only on your own life but on the lives of those you care about. Online resources will give you all the guidelines on how to approach the conversation about death and your end-of-life wishes. Many documents are also available to help you record your wishes in a legal way so they can be implemented.  Take the time to do it while you still have the time.