Making End of Life Decisions

You are never too old to complete an Advance Directive so you can stay in control of what happens to you. 

Spoiler alert: Everyone dies. The only part you can control is how you choose to live until the end comes. If you’re afraid to face it and avoid planning for it, chances are it will be a rougher journey for you and your family.

Are you the kind of person who believes that you should be kept alive regardless of your condition, even if you need to be on life support for the rest of your time on earth? If so, you need a decision-maker who understands these wishes.

Or are you the type of person who hopes that you just go peacefully in your sleep? Are you a grab-the-bull-by-the-horns person who wants to check off everything on your bucket list and go out with a last big hurrah?  If so, conversations with loved ones and a short form can go a long way toward you getting what you want.

No matter what your goals of care, without “the talk” or paperwork, you’re much more likely to spend your last hours or days in the hospital on machines, leaving your family to guess your wishes to make decisions about “pulling the plug”.  The following are some common misconceptions that prevent people from taking charge of their life before it’s over.

1. My family already knows what I want. You might think they do, but the biggest burden that families have when a loved one is dying is having to make decisions without really knowing what the person wants.  They may disagree.  Help them understand so they aren’t fighting or left feeling guilty as well as sad. Want a tool to help see how much they do know? Visit the Vermont Ethics Network website (https://vtethicsnetwork.org/medical-decision-making) and search for the Medical Decision-maker Quiz.
2. If I put it in writing, I won’t be allowed to change my mind.  If you’re able to make your own decisions, what you say goes. Advance directives, including the authority of an agent/proxy, are not followed unless you can no longer speak for yourself.  Choose a Health Care Agent who will follow your wishes.  If your wishes change, all you need to do is update your document.
3. I already have an advance directive (living will), so I’m all set. Maybe yes, but maybe no. Many forms are not as clear or specific as people think they are. Also, most people are not aware that an advance directive may not be enough. Health care workers are required by law to perform CPR unless they have an order from a doctor, nurse practitioner, or physician assistant giving them permission not to.  You may want to ask your provider to help you create a COLST form, the official order to ensure your wishes can be followed.

Stay in control of what happens and take the weight off your family’s shoulders. Talk to your healthcare provider to understand your options and do an advance directive.  Forms and conversation guides are available for free at vtethicsnetwork.org, or contact your provider or Rutland Regional Medical Center for help.