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Rev. Dr. Martha R. Jacobs

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Death And Taxes: Why We Need To Talk Openly About End-of-Life Care

Posted: 04/13/2012 2:29 pm

This coming Monday, April 16, is National Health Care Decisions Day. It was started to inspire, educate and empower the public and providers about the importance of advance care planning. I have written many times in this blog about the importance of people having advance directives. This is not a form of a "death panel," it is a way to empower those who may need to make health care decisions on your behalf, to do so in an educated manner.

When someone is in the hospital, it is already too late to begin to have a conversation about what someone's wishes are concerning how they want their body treated as they near the end of their life, or as they deal with a life-altering illness. While no one knows exactly how they will feel when something does happen, having had conversations with those who love you and who you love, will enable them to begin to understand what is important to you, what "living" and "life" mean for you. And since living and life mean different things for different people, it is all the more important to talk about it!

I also believe that God expects us to be good stewards of our bodies and our resources. We need to plan ahead and we need to ensure that we are not wasting resources, whether they be financial or medical. Completing an advance directive is being a good steward.

There are several websites below that can help you with these conversations, the conversation that no one wants to have, but everyone should have. Anyone over the age of 18 should have had these conversations, because the two women who sparked the advance directive movement -- Karen Ann Quinlan and Nancy Beth Cruzan -- were both in their 20s. While we my think that illness is not going to overtake us, chances are, it will. And we are living longer, with more chronic illnesses. You need to decide how you want to live your life with that chronic or debilitating illness.

While parents may think that their children are loving, compassionate people, scenes I have witnessed in the waiting room of an ER or ICU belie that. It is not that your children aren't loving, caring people, but when a parent is ill or dying, all of the sibling "stuff" that was there when they were young children, comes out again in full force. I have watched siblings push and shove each other and almost get into a fist fight over whether or not their mother would have wanted to be kept alive by a machine when she would not have any quality of life that was acceptable to her (based on what she had told one of her children).

When I do workshops with community groups about completing advance directives, I highly recommend that the family all come together, face to face, if possible, and begin to talk about what is important in life to each one of them. Yes, it is a hard conversation to have, and yes there will be tears, but there may also be some laughter and there will be love and there will be an opportunity for everyone to hear for themselves what the other's want in terms of being kept alive by machinery.

If you want everything done to keep you alive no matter what, that is fine -- just let people know that. If you don't want everything done to keep you alive if your quality of life will not be acceptable to you, then people need to know that too. If we learned nothing else from the Terri Schaivo case, it is that we need to make sure that all of those who love us know what our wishes are. The government is not stepping in to make decisions but they have passed legislation so that we can make our wishes known.

Benjamin Franklin did say it best in 1789: "'In this world nothing can be said to be certain, except death and taxes." So, in addition to preparing your tax return, take the time to prepare your advance directive. Below are several links to websites where you can easily download the form that is accepted in your state. As I said in a prior blog posting, the greatest gift you can give to your family, is letting them know what your wishes are regarding how you want your body treated as you near the end of your life.

 
 
 
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