Cultivating Wellness by Talking About Choices: Advance Care Planning for Everyone, Post #1

Advance Care Planning may not be something that excites you.  It’s certainly not glamorous. In fact, in our youth-focused, death-denying culture, planning ahead for medical decisions is something we tend to avoid, and actually talking about our wishes is practically taboo.

Don’t be too quick to dismiss or avoid the topic of Advance Care Planning.  You might not know what you’re missing. It does have its charms. It’s not just that it’s wise to plan ahead–although of course it is:  there are all kinds of predictable and unpredictable benefits to going through this process.

Here are four reasons why I am passionate about Advance Care Planning:

1. We are starting a revolution. Is that overly dramatic? I don’t think it’s overstating the issue to say that those of us who talk openly about quality of life, medical decisions and end of life choices are leading culture change. Like I said, this is a culture in which we can barely get away with saying the D word out loud, even–or especially–in a medical setting. And yet, what could be more essential to the human experience? How much of our full experience of life are we limiting by going to such great lengths to deny our deaths? How much does this avoidance marginalize our elderly population and those living with serious illness? We have an opportunity to normalize the conversation around what matters most to us when we are sick or dying. All we need to do is talk about it. That’s what Advance Care Planning is all about.
2. Advance Care Planning improves quality of life. Advance Care Planning is not just a process of filling out legal documents or signing DNR forms (more on those later). It is an ongoing, in-depth exploration of our goals and our values, what’s most important to us, and what we might want if we were in a vulnerable situation. It requires us to really define what quality of life means to us. How often do we stop to really consider what matters most to us in life? And where might that lead us? Could it help us live with more gratitude and more intention? Advance Care Planning also asks us to share what we learn about ourselves with our loved ones or our intended decision makers. Again, how often do we really talk about what matters most to us, and where might that lead us? Could it help us have better communication with and connection to those we love?
3. Advance Care Planning gives us control, security and peace of mind. It might be scary or distressing to spend time imagining ourselves in a difficult medical situation, but doing so gives us so much more control over how that situation will actually go if or when it arises. If you think through your goals and values and how they inform your future medical choices, talk that through with your future decision makers and put it in writing, you are giving yourself the security of maintaining control over health care decisions that you would otherwise lose. There is no peace of mind in pretending we won’t ever get sick and need medical care, but there is peace of mind in taking steps to improve the likelihood that that stage of our lives will be managed in a way that is consistent with who we are and what we care about.
4. Advance Care Planning is a gift to our loved ones. I am certainly not the first to say this, but it bears repeating. Imagine there is an unexpected event such as a car accident or a stroke, and you are on life support machines in the ICU. Your family members have gathered and the doctors are asking them what to do next. Do they know what you would want? Do they all agree? Or are they guessing and arguing because they are unprepared to make this kind of a decision? Maybe you’ve been on the other side of this scenario, the one having to make the decisions. At the very least, I bet you’ve seen this play out on television or in the news. Things can get ugly. I met a family once who were still divided and not speaking because they had disagreed about a medical decision for a loved one who had died 20 years prior. No one wants that for their families. We know that families of those who have done good Advance Care Planning fare much better in the long run than families of those who have not. Doing this planning in advance may sound daunting, but it is not as daunting as making a decision for someone else when you don’t know what they would have wanted.

You may not be as fired up about Advance Care Planning as I am, but I hope the four reasons for my passion about it have given you something to think about and at least nudged you toward doing your own planning and encouraging others to do theirs.  It’s time to start talking.