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Imagine getting a sudden call that your loved one is hospitalized and unconscious. You have moments to decide whether they should undergo an invasive treatment that could prolong life but with a high possibility of pain, or forgo treatment and minimize discomfort but with a possibility of sooner death. Would you be able to confidently provide an answer on what your loved one would prefer?
Preparing for the future is often a daunting process. We often only realize its importance once we face these unexpected crises. According to research, despite knowing the negative impact of not preparing such documentation, only one in three older adults in the U.S. have completed any advance care planning documents (Yadav et al., 2017).
Advance care planning is a process that allows us to talk about these critical but often avoided topics, to be prepared for the future. Everyone age 18 and above is recommended to complete the various documents related to this process – yet these documents are frequently associated with individuals who are older or near the end of life. Therefore, many people may not be as motivated to fill them out.
Keiro interviewed two aging experts: Helen Dennis, syndicated columnist, author, and expert on aging and the new retirement, and Dr. Sara Zeff Geber, the author of Essential Retirement Planning for Solo Agers, and a professional speaker on solo aging and the importance of building community. They provided insight on the importance of having these directives, with some tips specifically for solo agers, and factors people should consider when preparing for their future.
Advance Care Planning 101
Advance care planning is the process of conversing, understanding, and documenting what your choices are, should you no longer be able to make your own decisions.
Dr. Geber mentions that 70% of the population will need some care at some point in their lives, which is why having these documents would be important. She shared that advance care planning is “doing the uncomfortable work of putting yourself into that situation, and finding a way to feel comfortable about your later years.”
Advance care planning can include financial, health care, and end-of-life decisions. There are a number of documents and discussions necessary to prepare for the future. Some examples of these documents include (but are not limited to):
- Advance Health Care Directive
- Durable Power of Attorney
- Living Trust
- Last Will and Testament
Dr. Geber said each state has its own advance health care directive form, and requirements for completing it may vary. Some of the documentation does require consultation with your physician, financial planner, and/or estate planning attorney.
The benefits of these documents lie in providing all the answers needed in any crisis and knowing what course of action to take if such a situation happens where a trusted loved one needs to act on your behalf. Having a plan in place helps you and your loved ones have peace of mind.
Starting and Ending with Conversations
While the endpoint is to have this documentation completed, Helen said that an essential part of advanced care planning is having discussions to find the answers to these questions. Before getting started, valuable tools like the Five Wishes or the resources on the website Conversation Project can help us start thinking about our preferences.
While it may be daunting, thinking about different scenarios can help start the conversation. Helen added, “If it’s hard for someone to imagine, let’s remove ourselves from the situation and say, ‘If you’re advising someone who is in a crisis, what would be your advice?’ From this, you can eventually realize how significant this process is.”
The other essential point both experts mentioned was to converse and share your preferences once you finish the paperwork. Without sharing your preferences and plans, loved ones can get blindsided by the decisions made or be surprised they were designated as a proxy (a person representing or acting on behalf of someone) without their knowledge.
Unique Factors to Consider for Solo Agers
The key challenge for solo agers is figuring out who will be their proxy making decisions on their behalf. Dr. Geber said the first group of people they can look to is their extended family, such as a niece or nephew. She, however, cautioned putting friends as their decision-makers. “There is a lure of choosing friends. Some name their best friend, but they may be around the same age, and you don’t know who will go first. The other person then will be left on their own.”
For those who are solo agers or anyone who is uncomfortable putting their family members as a proxy, Dr. Geber recommends professional licensed fiduciaries, who are professionals hired to be the mediators to make decisions based on the documents completed.
In preparing for the future, Helen also added the importance of having a solid network of friends and having a financial plan to think about what resources they would need to continue aging in their manner. “Be an initiator, and don’t wait for the world to come to you. It’s your story to write. Don’t wait for others to write for you.”
Looking out for Each Other
Talking about our own mortality is not a fun process, and some may want to avoid it or do not recognize that they need to talk about it and instead assume others know. However, without putting these decisions on paper, challenges may arise for loved ones left to deal with a crisis. For those struggling to get someone to talk about these topics, Dr. Geber recommended continuing to casually bring up the idea, such as gently introducing a story of someone else, to get them to start thinking.
Helen also added the importance of community and support by reaching out and looking out for each other. “We know loneliness is an epidemic. We need people around,” she shared. “If there is someone on their own, invite them to coffee or dinner parties to meet others and check in.”
The Best Gift to Give
Dr. Geber and Helen said preparing and having these conversations is the best gift you can give to those left behind.
Helen concluded that with such a dynamic environment where things are uncertain and unpredictable on a societal level, getting these documents in place is one way we can take more control and initiative in our own lives. “You’ll never have control over your mortality, but you have a high degree of influence, and there IS a way to take charge. Sometimes this is having the conversation and support around these issues.”
Keiro is starting a new series to encourage everyone to talk about advanced care planning. If you are interested, sign up for our email newsletter for updates on the launch of this series!
Sources
Yadav, K. N., Gabler, N. B., Cooney, E., Kent, S., Kim, J., Herbst, N., Mante, A., Halpern, S. D., & Courtright, K. R. (2017). Approximately One In Three US Adults Completes Any Type Of Advance Directive For End-Of-Life Care. Health Affairs, 36(7). https://doi.org/10.1377/hlthaff.2017.0175