Plan Ahead for End-of-Life Empowerment

August is "National Make a Will Month." (And if "National Lost Sock Memorial Day" and "National Nothing Day" hadn’t already convinced you, surely this proves once and for all that there is a national “holiday” for everything.) All joking aside, end-of-life planning is an important thing for everyone to do, and August coming to a close doesn’t mean you should put it off until next year!

Many people think of estate plans as things only wealthy people need. But in reality, they are the means by which any of us can make our wishes known and enforceable should we no longer be able to do so ourselves. This doesn’t just apply to assets, either; thinking ahead and creating a plan can help you outline important information about how you want to live the last phases of your life.

An estate plan may be simple or complex, depending on your wishes and assets, but is typically made up of some combination of the following planning documents:

  1. Living will/advance directive (specifies how medical decisions will be handled if you are unable to make decisions on your own).

  2. Last will & testament (legal document detailing how your assets are handled and what happens to your dependents).

  3. Living trust (manages assets while you’re living and after you die; a good option for more complicated estates).

  4. Powers of attorney (grants people you trust the legal authority to make legal, financial, medical or business decisions on your behalf if you are no longer able).

Other documents can also be included to give important information about your wishes and communicate important messages to your loved ones. These include:

Planning for pet care can also be an important part of end-of-life planning.

  1. Organ & tissue donation designations (specifies which organs or tissue you would like to donate upon death).

  2. Housing and long-term care plan (where you would like to live and who you would like to provide care in various circumstances).

  3. Pet plan (to ensure your fur babies receive the care they need when you’re gone).

  4. Legacy letters (one or more letters you leave behind to express your values, heritage, relationships, hopes, memories and stories to your family and friends).

  5. Obituary (if you would like to write your own).

We’re not experts in estate planning, so when it comes to the nitty-gritty of creating a will or other legal documents, our advice is to find an estate planning attorney or use a reputable online tool like Trust & Will. But we have been providing end-of-life care for people in our community for more than four decades, and what our experience tells us is this: the clearer you are about what you want, the more intentional you are about setting things up to happen the way you’d like and the more you engage and communicate your plans to your loved ones, the more empowered you are likely to feel at the end of life.

We know, we know…thinking about your own eventual death probably isn’t something you enjoy, and your loved ones likely aren’t big fans, either. But pushing it down the road too long can lead to unfortunate situations. Without putting your wishes in writing to clearly define what kind of medical interventions you do or don’t want in certain circumstances, or where you want to spend your last months and days, your family or your doctor will be left to make those decisions for you – and in the high emotion of the moment, may choose a path that isn’t the one you would prefer.

On the other hand, thinking through how you would like things like emergency medical care, housing or long-term care, end-of-life care, burial – even your pets’ care! – to be handled helps ensure that your wishes are respected and prevents your family from being faced with the unnecessary stress of wondering if they’re doing the right thing. Plus, there can be significantly different costs associated with different preferences; planning ahead can help you develop a savings plan or identify more affordable alternatives.

In hospice, we work directly with patients and their families to create a care plan that reflects your unique preferences for physical, emotional, social and spiritual care at the end of life. In the best of cases, these can be difficult but beautiful conversations that align the family’s expectations and bring people closer together for the time have remaining together. But you don’t have to wait until you need hospice care for the peace of mind that comes from identifying your preferences and knowing you’ve given your loved ones the gift of clarity about what you want.

Advance planning provides the peace of mind you and your loved ones need to focus on what matters most while you’re here.

Advance planning provides the peace of mind you and your loved ones need to focus on what matters most while you’re here.

So how do you begin? Creating an advance directive is a good place to start. In Oregon, the advance directive form is a straightforward worksheet you can fill out yourself and sign with a witness or notary. It asks a variety of questions about various medical situations and lets you choose the level of intervention you would like for each. It also allows you to name a healthcare representative to make decisions on your behalf if you can’t speak for yourself. And it’s a good introduction into the kind of if-this-then-that alternatives you’ll need to think about when it comes to your living situation, long-term care needs, end-of-life care preferences and burial options.

The advance directive can also be a good way to introduce discussions about death with your family. Even in families who are comfortable candidly discussing death, it can be difficult to really dive into the details. Having the advance directive form as a clear guide for an initial discussion can help organize your thoughts and take a matter-of-fact approach to reduce anxiety, while also creating the opportunity to talk about other things that have been on your mind, what other plans you are making for the latter part of your life and what questions or concerns your loved ones might have.

If you’re still having a difficult time thinking about your own preferences or talking with your family, you may want to enlist help. There are many resources online, like the conversation starter guides from The Conversation Project, the “Consider the Conversation” films and discussion guides and Five Wishes. Or, you may wish to talk to a counselor who can help you identify and work through emotional roadblocks to thinking and talking about death, and/or an estate planning lawyer who can guide you through the specifics you need to consider.

As daunting as it may feel at first, end-of-life planning can be an empowering and reassuring process. And remember: you don’t have to do it all at once; just start.

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Healthcare Decisions Day 2022: Start the Advanced Care Planning Conversation

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The Hospice Suitcase: Support for the End-of-Life Journey