Begin With the End in Mind (part 2)

Begin With the End in Mind (part 2)

 What could go wrong if you never get around to end-of-life planning? Plenty.

“I’ll wait until I have to.”   That’s a huge gamble, since somewhere between 28-68% of patients at end-of-life lose the ability to make medical decisions for themselves.

No POA? You and your family are at risk. If you become unable to make medical decisions for yourself, and haven’t chosen a legal Power of Attorney for health care, Wisconsin law requires the court to appoint a guardian for you. This requires 3-5 business days (at best), costs about $1500 in legal fees (at best). Any family conflict? Well then, let’s make that more like a month’s delay and $5,000 in legal fees – and all this on top of an already upsetting situation.

Patients without end-of-life plans don’t do well. They suffer more. They don’t live as long. And their care costs much more.

Families suffer without advance directives. “My family knows me, and they know what I’d want.” Are you sure about that –I mean REALLY sure?

Have you ever bought a house jointly with anyone? Did you ever feel nervous about making an expensive decision without consulting your partner?

How often does someone you love call to double-check something trivial? Maybe I’m the only one, but my wife Sara calls me to double-check about a lot of things that: a) we’d already discussed, and b) aren’t very important. And I do, too.

Most of us don’t want to make the wrong decision on behalf of someone we love. How confident would you feel making end-of-life decisions for a loved one who’d given you only the most general instructions. Here are some examples of unhelpful directives:

  • “No heroic measures”
  • “If I’m going, let me go”
  • “I wouldn’t want life support if things got too bad”

Making these kinds of decisions without guidance puts loved ones in a terrible position. No matter how well you know someone, it’s hard to feel confident you’re choosing correctly if you’ve never discussed their wishes. So it’s no surprise that families of patients without advanced directives suffer higher rates of depression and complicated grief.

You can’t afford not to think about dying-about the kind of medical care you would and wouldn’t want at the end of your life. And you can’t afford not to tell your loved ones about your wishes.