How to Talk About End of Life Planning

The COVID-19 pandemic is a time of great change and uncertainty in our community, and has brought increased awareness of our own mortality. As Hebrew SeniorLife’s Clinical Director of Palliative Care, I see every day why it is important to discuss what medical care you wish to receive if you become seriously ill. Completing an advance directive is one thing we can all do to help us maintain autonomy in the midst of challenging circumstances.

Regardless of your age or health status, now is a great time to explore advance care planning. It’s especially important if you have a life-limiting illness or dementia diagnosis that could prevent you from making your wishes known in a crisis situation.

Advance care planning is the process of thinking about, talking about and writing down your health care wishes. It is the best way to ensure that your wishes are known, understood and respected.

Here are four steps to help you and your family get started:

• Think about what is important to you and how you want to receive care. The decisions you make will come from self-reflection. You may ask yourself, what makes my day worthwhile? What are my hopes and my fears? Are there any medical treatments I know I would not want? Thoughtful consideration of these questions will help shape an advance directive that is right for you.

• Select someone to speak for you if you are ever unable to speak for yourself. This person will be named your Health Care Proxy. An ideal Health Care Proxy knows you well, is able to discuss sensitive issues, and is someone you feel confident will respect your wishes. This person will be empowered to make health care decisions on your behalf, if you are ever unable to speak for yourself.

• Talk about your health care wishes. Find a time to speak with your Health Care Proxy and other important people in your life about your wishes. Starting the conversation takes courage.  Be patient with yourself and your loved ones on this journey - every attempt at a conversation is valuable.

• Put your choices in writing. The most important document to complete is the Health Care Proxy form, which names your chosen health care agent. If you want to put more of your wishes in writing, you can also complete other advance directive documents, such as a Medical Orders for Life Sustaining Treatments (MOLST) form, in partnership with your health care team.

At Hebrew SeniorLife, the palliative care team guides patients and families in having these sometimes difficult or challenging conversations. We are able to support families as they participate in these transitions and make decisions with their loved ones. We offer palliative care consultations for inpatients at Hebrew Rehabilitation Center, and also through our Home Health services.