Dan Morhaim, MD, author of the position paper End-of-Life Care Issues: A Personal, Economic, Public Policy, and Public Health Crisis, which recently appeared in the Journal of Public Health, says too few Americans have an official plan for end-of-life care, and everyone should—especially those who may be facing these issues sooner rather than later.  “It’s important to make a plan for end-of-life care to tailor your treatment to your personal wishes,” says Dr. Morhaim. “This also relieves your loved ones from the burden and guilt of decision making.” Dr. Morhaim, who is also the author of The Better End, suggests five end-of-life questions everyone should ask themselves:  

  1. When should I start planning? Now, especially if you’re already ill or have received a bad diagnosis. The more competent you are mentally, the better able you are to plan. 
  2. How do I decide what kind of care I want if I become critically ill? Medical care is a personal decision that reflects your values and circumstances. Most Americans choose continuing medical care if there’s a chance of meaningful recovery and some quality of life. If not, many prefer not to institute heroic measures. Your physician, your attorney, key family members and your spiritual advisor can help you decide what options you have in numerous situations and how you might like to proceed. 
  3. Once I decide, how can I make my wishes known?By filling out an advance directive (AD). It is a legal document that allows you to spell out your decisions about end-of-life care. By making it legally binding, there is no question about how to proceed should you become unable to communicate. That way, if there is disagreement among your family for how to proceed with your care, your wishes take precedence. These forms are available online and from hospitals or attorneys. They are free, cost nothing to complete, and are legal in every state. Some states may require them to be notarized and/or witnessed. You can “tweak” your AD as often as you like. The most recent is the one that is used. 
  4. Who should make medical decisions for me if I can’t?Someone you trust and with whom you’ve had a discussion about your values and desires. Typically, it’s a spouse, adult child, or close personal friend. Bringing it up in conversation might be the hardest part. Every family is different and there will always be some who are resistant to speaking about something so painful. You may just have to keep trying. 
  5. Once I complete an AD, what should I do with it?Make sure your health care agent, your doctor, your hospital, your attorney and your family have a copy. It should be available if needed, so don’t hide it away.  It’s understandable not to want to think about this gloom and doom but the more prepared you are for major medical events the easier it is for everyone involved.