If you had 24-hour notice of an impending disaster, what would you try to save in your home? In an emergency, there is no time to hem and haw. Priorities have to be established and decisions made quickly. Organizers use this question sometimes to help clients determine what is valuable to them – it can serve as a starting point for the decluttering process.
Consider this question: if you had 24-hour notice of your death, what would you do? Like the previous question, this one helps people get in touch with their values and prioritize. Many people would say they’d want to spend time with family and friends. Now let’s add a twist: with that 24-hour notice the nature of your death is omitted. It may be a peaceful letting go process in your sleep or you may experience great suffering before dying. How would you want your loved ones to respond? If you think your friends and family will accurately extrapolate your wishes based on their relationship with you, think again. A study showed that spouses incorrectly guessed 50% of the time what their partner’s wishes are for how they want to be treated in the face of a terminal illness and impending death. Yep, 50% of the time. Let that sink in. Without communicating explicitly what you want, you have a good chance of receiving the type of care you really don’t want.
The obvious deduction is to communicate explicitly what you want and follow-up by recording your wishes. Ideally, you want to create an advance directive such as a Durable Medical Power of Attorney, which names who should make medical decisions for you if you are unable to make those decisions and provides instructions about the types of treatment you do and do not want. And naturally, you would want to involve the person you want to appoint as your proxy. You may find out that the person you want to appoint as your proxy does not want the responsibility. Or you may find out that your designated proxy has a completely different perspective on dying than you do. Minimally you’d want to prepare your designated proxy for the responsibility. Unfortunately, some people are surprised with the news that they have been named as a patient’s proxy when the patient’s death is imminent. That’s a nasty surprise.
So how do you get started? Do you just slip the topic in while you’re talking about something else? “Joe, I think we need to paint the living room a lighter color. And by the way, can I tell you about the types of medical interventions I do and do not want when I’m dying?” I suppose you could. You might not have the type of discussion you imagined though. Starting is often seen as the toughest step. Luckily, there’s help. The Conversation Project is an organization that is dedicated to having everyone’s “wishes for end-of-life care expressed and respected.” Their website has a starter kit and lots of great tips for having a conversation about your wishes. Another great resource is Five Wishes. Five Wishes provides a framework for discussing the five most important points regarding advance care planning. After you’ve discussed your wishes with the people you love I encourage you to formalize your discussion by seeing an attorney to create your Durable Medical Power of Attorney.
There’s one thing that is certain: we are all going to die. We just don’t know when, where or how. The uncertainty is reason enough to live the best life that you can now. That includes providing you and your loved ones with the peace of mind that comes from planning.