Advance Directives

In these strange and uncertain times, many of us have found ourselves confronting mortality in ways we never dreamed of. As we hear stories on the news and in real life of COVID-19 patients separated from loved ones during their last days, we are reminded of the importance of making our end-of-life wishes known to our loved ones and health care providers. This recent article by a doctor in a COVID-19 unit makes a very compelling case for discussing end-of-life care now.

In good times, end-of-life situations are often difficult to discuss. We would rather not face dying or having to say goodbye, so our inclination is to put off these conversations. In fact, according to the non-profit The Conversation Project, while 92% of Americans say it is important to discuss their wishes for end-of-life care, only 32% have had such a conversation.  As a result, too many people die each year without having their end-of-life wishes expressed and respected.

Engaging in conversations about end-of-life wishes helps to normalize death as a part of life and can bring loved ones closer together. Equally important, having these conversations affords us an opportunity to set intentions for how we want to live our lives. And now, with the coronavirus crisis upon us, it is even more important for us to engage in these difficult conversations. While most of those who contract the coronavirus will recover, it is crucial for us to plan for the possibility that we may not.

Fortunately, there are some wonderful resources online to help us engage in these conversations, make our wishes known, and create an advance directive, a legal document that explains how we would like medical decisions made about us if we cannot make them ourselves. Exploring these resources will not only give us peace of mind but also potentially prevent our loved ones from experiencing conflict and regret surrounding our end-of-life care.

• Reimagine End of Life (www.letsreimagine.org) is a nonprofit that uses the arts, spirituality, health care and design to spark creative community conversations exploring death and celebrating life. Their website encourages us to recognize the advantages of having these conversations at any age.
   
• The Conversation Project’s The Conversation Starter Kit (www.theconversationproject.org) is a free resource designed to guide individuals through the process of identifying and sharing their end-of-life wishes.
   
• Five Wishes (www.fivewishes.org) is an “easy-to-use legal advance directive document written in everyday language.” It also helps to guide and structure discussions and, unlike a traditional advance directive, it addresses one’s personal, emotional, and spiritual needs in addition to medical ones. There is a small charge to access this document. 
   
• The Hospice Giving Foundation (www.hospicegiving.org) helps individuals compile important personal, health, and financial information in one place through its free Notes to My Family document. 
   
• The State of Maryland has an advance directive form on its website (www.maryland.gov). Even those who don’t have the time or desire to complete Section 2 identifying their specific treatment preferences can use this document to simply name a health care agent who advocate for them should be unable to speak for themselves.
   
• Finally, My Directives (www.mydirectives.com) is an app that allows individuals to create a state-of-the-art emergency critical and advance care plan that can be easily updated and shared with anyone including hospitals at the time of admission. 

Perhaps a silver lining of this coronavirus crisis will be that it encourages us to take the time to have these meaningful and perhaps overdue conversations. Please don’t hesitate to be in touch if I can be of assistance as you consider, prepare for, or engage in these conversations