Thursday, December 26, 2013

Why It's Essential to Prepare an "Advanced Care Directive"

Being a hospice volunteer has caused me to become more aware of my own mortality. Death is less

an abstract concept about something that will happen out there to someone else at some time in the future. That awareness has caused me to be more intentional in planning for the inevitable.

An essential part of that planning is creating an advance directive regarding the kind of medical care I wish to receive at the end of my life.

Here's what's involved:
  1. Designate a person to be your patient advocate. Depending on the form and where you live, the advocate may be given a different title. Regardless, this person is given your durable power of attorney for health care and is responsible for making important decisions about your care should you be unable to do so. Forms are available at most doctor's offices and health care facilities, including Arbor Hospice.
  2. Have the patient advocate sign the form indicating acceptance of the responsibility.
  3. Create a living will that describes the kind of care you wish to receive at the end of life. Preparation of a living will can be informed and enriched by the use of planning tools such as Five Wishes and the Go Wish Game.
  4. Have one or more conversations with your patient advocate so he or she knows specifically what you do and do not want. The tools mentioned above can provide ideas and terminology that enable these discussions. Have similar conversations with family, friends and others with whom you are close to avoid confusion or conflict should a situation arise that requires the patient advocate to act on your behalf.
  5. Make certain that your physicians, health care system and family members know whom you have designated as a patient advocate and that they have copies of your living will. Take your durable power of attorney for health care and living will documents with you if you are hospitalized or are traveling.
Having end-of-life conversations and making these decisions may be difficult. Yet, they are truly a gift we give not only ourselves but those who care about us as we relieve them of the responsibility of guessing our wishes.

We also lessen the likelihood of misunderstanding and conflict among family members as they act on the wishes we've expressed in our living wills.

These are gifts that can extend well beyond our lifetime.

This blog post was written by Dennis Sparks, Arbor Hospice Volunteer. You may contact Dennis by commenting below or emailing him at


  1. Thank you, Dennis, for this important reminder. Taking the time to think about and then communicate your end of life wishes relieves many burdens from our loved ones, especially if they are having to guess about our wishes while under duress.

  2. Dennis, great reminder and "5 Wishes" is such a fantastic tool. In fact, I just gave a family member a copy, an extra one I had in case I made a mistake on my own. The only mistake I've made on my own form is not completing it. I don't make New Year's resolutions, but my goal is to complete my own "5 Wishes" by Valentine's Day -- as a gift to all my loved ones. Please help hold me accountable, ok?

  3. I would be happy to be your "Plan B," Laura, and will remind you about it on Feb. 1. Another way to accomplish your goal—a "Plan A"—might be to have a "5 Wishes" party or dinner with family members and/or friends (or Arbor Hospice colleagues) during which participants would complete their forms. Many of us benefit from the conversations and group support that such events provide.

  4. Thanks Dennis - I'm on about "Plan K"...

  5. I've put my partner's durable power of atty for medical care form in my car's glove compartment, and mine in his. If you get called to the hospital in an emergency you don't want to have to return home to pick up the papers. We live out in the country and are often in Ann Arbor, so it would be an hour round-trip drive home and back.

  6. What a great idea, Lorri! Thanks for sharing it... I wonder if other readers have suggestions for keeping Advanced Care Directives close at hand in case of an emergency.