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Why You Need to Make Your End-of-Life Wishes Known

End-of-life conversations are critical. Start them today.

By Sherri Snelling | April 18, 2012

One of the most important things we can do for ourselves as we get older is to ensure that our end-of-life wishes are clear, that they have been communicated to our loved ones and rendered in a way that is legally binding — in fact, Americans of any age should make sure their end-of-life paperwork is in order. While you can spend a lot on legal fees for living wills, advance directives for end-of-life care, durable power of attorney documents for medical and financial decisions, do not resuscitate orders and similar documentation, there is a more affordable, equally binding alternative: Creating a living will on LegalZoom.com.

Creating the documents is the easy part, though. Having the conversation about your directives with your loved ones is often more difficult.
 
Start Here

There is a $5 tool that can help you start that conversation. It is called the Five Wishes, and it was created in 1997 by Jim Towey, a longtime legal counselor for Mother Teresa of Calcutta. So inspired was Towey by his experiences as a volunteer at her homes for the dying that he created a non-profit organization, Aging with Dignity, whose purpose is to share and promote the document, which he has called “a living will with a heart and a soul.” (Towey later became director of the White House Office of Faith-Based and Community Initiatives under President George W. Bush.)

The Five Wishes explains options and asks questions that help you make decisions covering your medical, personal, emotional and spiritual needs. The answers can help you communicate how you want to be treated if you become too ill to speak for yourself:
 
1. Who do you want to make health care decisions for you when you can't make them yourself?
2. What kind of medical treatment do you want and which treatments would you decline?
3. How comfortable do you want to be?
4. How do you want people to treat you?
5. What do you want your loved ones to know?
 
This downloadable document (it can also be mailed to you) has been completed by millions of people worldwide and translated into 26 languages and Braille. It meets the legal requirements for an advance directive in 42 states, and in the other eight, you can attach it to the specific forms that the state requires.
 
Why It Matters

The Terri Schiavo case in St. Petersbug, Fla., reminds us of the agony and antagonism that can tear families apart when a patient’s end-of-life care directives are unknown. Schiavo was 27 when she was put on a ventilator and feeding tube after cardiac arrest left her in a persistent vegetative state. She lay in a vegetative state for 14 more years, while her husband battled her parents in court over whether or not to keep her alive. He eventually won the right to have her feeding tube removed and she died in 2005. But had Schiavo had a living will, there would have been no battle.
 
Another way to raise these issues with your family is by viewing the documentary, Consider the Conversation: A Documentary Film About a Taboo Subject ($29.95). The DVD, created by a hospice worker in partnership with a teacher/filmmaker, explores how and why dying is a topic that most Americans do not want to discuss. Despite enlightenment in other areas — families gather, for instance, in front of televisions to watch reality shows and cable news specials tackling previously taboo subjects, like religion and sex — dying remains off-limits. And yet, it's a topic we need to explore together. Forty years ago people did not live as long as they do today, mostly because we did not have the technology or medical interventions to keep them alive. Because dying today is, however, a long, slow process, it requires more dialogue. Watching this film can spark the conversation about what we would want if we could not express our end-of-life wishes ourselves.
 
The harsh reality is that if you do not have this conversation, family members can be confused and conflicted and end up having emotional exchanges you would never wish upon them. Dying is not a choice, but how the end will come is. We owe it to our families to share our wishes. Now is the time to start talking.