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Health Care Planning Starts at the Kitchen Table

Before putting it off again, ask yourself: Would you rather have a say in the most important decisions of your life, or leave them to chance?

Son talking to father with paper and laptop in kitchen, Health care planning

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Health care planning begins with a thoughtful conversation among loved ones.

Most of us hold in our heart the story of a loved one whose death was either poignantly peaceful or excruciatingly painful. Too often, unfortunately, it's the latter. Final moments and final memories are marred by trips to the hospital, burdensome last-ditch treatments and unmanaged pain.

See also: Caregiving Resource Center

We have had ways to avoid such unwanted scenarios for more than 30 years.

Every adult can write a health care advance directive, such as a living will or health care power of attorney, to make his or her health care preferences clear and legally binding. Yet only about one-third of adults have done so.

The most common misperception about advance care planning is that it requires completing a complex legal document. In reality, such planning can start at the kitchen table through a thoughtful conversation with loved ones.

Focus on two questions. First, who can best serve as your health care agent or proxy to make decisions for you if you become incapable, even temporarily, of speaking for yourself? Second, what guidance can you give your proxy and others involved with your care about how you'd want decisions made?

It might be most helpful to start by answering questions such as: What would matter to me most at the end of life? What are my fears? Is the quality of life or the length of life more important to me?

Document your decisions

Once you have answers, make sure you document your decisions. The only legal document you need is one that appoints a health care agent, proxy or representative — the terminology varies by state. Forms are available through our online resource guide (PDF).

The actions you take — and decisions you make — will likely be influenced by your stage of life and health experiences.

A healthy 20-something typically won't have as much to say about end-of-life priorities but still needs to appoint a health care agent. Adults nearing retirement age may have more-formed opinions because of experiences with their own and others' serious illnesses. And a frail 90-year-old with an advanced, progressive condition may have very specific preferences for his last days.

At its best, advance care planning is a continuing conversation, not a one-time chat.

Talk to your doctor

Once you and family members have discussed your health care priorities, it's important to discuss them with your physician and get your advance directive into your primary health care record.

Since treatment today may involve multiple health care settings and multiple professionals, you or your health care agent may need to repeat this process many times. Some states have created advance directive registries to simplify access to your advance care plans. A few national directories also exist.

Our resource guide will help you start this important conversation. Before you find another reason to put it off, ask yourself: Would you rather have a say in the most important decisions of your life, or leave them to chance? If you want to have a say, contact your lawyer or doctor and start talking.

Laurel G. Bellows is president of the American Bar Association.

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