What is an Advance Care Plan and Why Do I Need One Before I Die?
Imagine this frightening scenario: You have a heart attack while driving. The EMTs successfully do CPR and you wake up on a ventilator in the ICU. You're unable to talk. You fight against being intubated so, in order to protect your health, you are sedated. While sedated, you develop sepsis and go into a coma from which you will never wake.
Your family has no idea what to do. How long to keep you alive. How to talk to you. How to care for you. How to make you comfortable. What would bring you a peaceful death?
No one likes to think about death. But it's reality. We're all merely mortal and the sooner we face our mortality, the better we can get on with enjoying life fully until we die. That phrase "until we die" literally encompasses our final days, but the details of our last 72 hours or so are rarely ever considered-unless you work with an End of Life Doula. We cover everything between the medical world and the funeral world to help you and your family members cope, have peace of mind, and be as comfortable as possible during your end of life journey. But that takes planning well in advance - Advance Care Planning that few people consider. Given recent world events, it’s never too early to start planning, relieve yourself of the stress, and lift the burden of decision making off your family members! Let's dive into what goes into your Advance Care Plan and how a Death Doula can help.
The Advance Care Plan Umbrella
An Advance Care Plan is a written summary of a capable adult’s wishes or instructions to guide your loved ones to make decisions about end-of-life care and healthcare treatments when you are not able to speak for yourself, in cases of serious illness, unconsciousness, or when you’re nearing death. This planning can, and ideally should, take place well in advance (hence the name) of your final days. This planning should happen while you are physically and mentally capable to make your own decisions, when you are younger and healthy, and can be revised as needed throughout your life, should your health or your priorities change.
The Advance Care Plan is a larger umbrella that encompasses several different documents that you may want to have in place for end-of-life planning, including:
- Advance Directive - Also known as your “Living Will”, these are specific medical instructions including CPR/DNR, ventilation, and pain control
- Representation Agreement - naming the person who will speak for you
- Enduring Power of Attorney - naming who will be the financial and legal decision-maker if you become incapable (different than “regular” POA)
- Funeral Home Selection and Bodily Disposition (e.g., cremation, burial, green)
- My End-of-Life Journey Wishes - This is where Death Doulas really shine and can help you out. This section, also sometimes referred to as Comfort Wishes, covers all the little details about your end of life that do not go into any of the above documents.
As you can see from the list above, there are several things to consider to be fully prepared in the event of the unforeseen.
What's the Difference and What are End of Life Journey Wishes?
You might already have a Will and a Power of Attorney with the Executor set up for after you die, but do you have someone to speak on your behalf if you are incapacitated? Would they know if you want CPR or not? Those specific notes would be covered in the Advance Directive and Representation Agreement, which I can make for you at a fraction of the cost that a lawyer or notary would charge.
As you can see, Items 1 and 2 are very medically-oriented, and your funeral wishes may be noted in Item 4 (and I can either help you with planning your celebration of life or refer you to one of my trusted colleagues). But what about everything in between?
Even if you already have a living will or advance directive, that doesn't mean that you have your end of life journey wishes prepared. The end of life journey expressed wishes cover the more intimate details of your final days. Such as:
Spiritual Comfort - Do you want a visit from a minister or someone in your faith community? Do you want any rituals or ceremonies performed before you transition to death or at the moment of your death?
Physical Comfort - Would you still want your hair done every day? Do you have favourite pillows you'd want from home?
Emotional Comfort - Do you want your hand held? Do you have a favourite book or poem you'd like read to you?
In each of those categories, those are just two of the many questions per section that I go through with my clients to make sure that your wishes are fully documented in our best efforts to help you live as fully as you can until the moment you die.
Having as much documented as possible not only helps take the stress off of you, but is a significant relief to your family members in what is sure to already be a stressful time. Why not give your loved ones the gift of lifting the burden off their shoulders, so you can all enjoy your final days together in a peaceful way with your maximized comfort and quality of life?
What Can I Do Now?
If you have some or all of the above documents already prepared, congratulations! You'd be well ahead of 90% of the population! If you're part of the 90%, let's get you started. I offer an Advance Care Plan Review, if you have some documents already prepared but you're not sure what you're missing. I also offer complete or partial Advance Care Plan creation, depending on your needs.
Don't wait until it's too late. Document what you would want to tell your family and loved ones about how they can best help you in your final days. Then you'll have peace of mind now and they will have peace of mind later. Contact me, Jennifer Timer, at Pacific Well-Being, to get started.