Think about end of life wishes now

My husband and I recently planned a trip to Disney World with our 7-year-old granddaughter. We have planned Disney trips over the years but things have changed. Technology and options at Disney have changed, and so have we. We are a bit older. We have different goals and priorities. So, our family has had many discussions about the trip to determine what is best for us at this time.

Trip planning is not unlike Advance (Health) Care Planning! Advance Care Planning is a process that, like trips to Disney, may occur throughout our lifetime. Planning for both a trip and for our health care, in case we are ever unable to speak for ourselves, involves thinking about our values, having discussions with our families and setting priorities. Both involve completing paperwork to formalize the process. By planning, we hope to have a smoother experience when the time comes.

National Health Care Decisions Week is April 16-21. It is a yearly reminder to discuss, create or review our advance health care plan. As Benjamin Franklin quipped, “Nothing in this world can be said to be certain, except death and taxes.”

Advance Care Planning is a process for adults regardless of age or health status. I think about Advance Care Planning in three stages. The first stage is for those who are younger and seemingly healthy. This stage is important because advance care planning laws resulted from tragedies that occurred to people who were in their twenties: Karen Ann Quinlan, Nancy Cruzan, and Terri Schiavo. Choosing a trusted spokesperson (agent), discussing general goals and values, and signing a Power of Attorney for Health Care is the first step.

Down the road, if diagnosed with a serious illness, we should learn about that illness and its possible complications. Since goals and values may change when faced with a serious or chronic illness, we should review our health care plan and have another discussion with our agents.

The third stage of Advance Care Planning is for people who may die within the next year. Healthcare goals and values in the face of an advanced illness should again be discussed with our agents and doctors. Documents should be reviewed and updated.

When patients cannot speak for themselves, families opt for the care they believe their loved ones would want. Professionals strive to honor a patient’s wishes. Unfortunately, without Advanced Care Planning, they often do so with little, if any, guidance. As a result, families may have long-term regrets.

Advance Care Planning is a gift to loved ones. Although 80 percent of people say it is important to “have the talk” and put their wishes in writing, only 23 percent have done so. Take some time this week to start the process. For a list of organizations that will help you review or complete an Advance Directive, contact the Community Outreach Department at Aurora Sheboygan Memorial Medical Center at 920-451-5332.


Ann Salzmann, RN, MA, is the Team Lead-Community Outreach for the Aurora Sheboygan Palliative Care Program and co-chair of the Aurora Sheboygan Memorial Medical Center Ethics Committee.