by Rozanne Van Rie, AWC Antwerp and FAWCO VP Member Clubs
Advance Care Planning
We have a huge opportunity!
Through conversations, we can transform the possibilities for the last chapters of our lives...
Not just our own, but for our loved ones, whether they are living in the next city or – as is often the case for expat women – across an ocean!
When??...is Advance Care Planning important?
NOW!!!!
Advance care planning is important throughout your entire life, including:
- When life changes – having children, death of a loved one
- Around major events like graduation, marriage, relocation, etc.
- Before major events such as vacations, hospital visits, etc.
- When you change your mind or before you lose it 😉
- When you are 18 or older
Remember, it is vitally important for you to do advance care planning before a crisis occurs. When decisions have to be made and communicated at this time, it is often impossible to do so without a great deal of stress – or even worse, to not be able to follow our loved one’s wishes! 
WHAT??....is an Advance Care Plan (ACP)?
Advance care planning is a process that enables you to plan your future healthcare.
It provides direction to healthcare professionals when you are not able to make or communicate your own healthcare choices.
Advance care planning is appropriate for adults at all stages of life, and can help reduce your stress and anxiety while improving your end-of-life care. I had an elderly patient who insisted that her granddaughter have an ACP before she received her gift for her college graduation.
There are great benefits to advance care planning and communicating your healthcare choices. Not only is it important for you to express your choices, it is a gift for your family.
PROVEN FACTS TO MOTIVATE YOUR DISCUSSION:
There’s a big gap between what people say they want and what actually happens:
- 60% say that making sure their family is not burdened by tough decisions is “extremely important,” yet 56% have not communicated their end-of-life wishes. * Survey of Californians by the California HealthCare Foundation, 2012
- 66% of family disputes about aging or end-of-life issues that end up in court could have been avoided if a family had clearly discussed and documented wishes in advance. * Home Instead Senior Care, U.S. Research Report, 40/70 Rule
- 70% of people say they would prefer to die at home, but 70% die in a hospital, nursing home, or long-term care facility. * Centers for Disease Control, 2005
- Senior care professionals surveyed say 70% of family conversations about aging are prompted by an event such as a health crisis or other emergency. * Home Instead Senior Care, U.S. Research Report, 40/70 Rule
- Most people say they would prefer to die at home, yet only about one-third of adults have an advance directive expressing their end-of-life care wishes. Among those 60 and older, only about half have completed an advance directive.* Pew, 2006; AARP, 2006
- Only 28% of home healthcare patients, 65% of nursing home residents and 88% of hospice patients have an advance directive on record. * Jones, 2011
- 82% of estate-planning attorneys surveyed recommended having discussions about aging and end-of-life issues before an adult child is 40 and before a parent is 70. * Home Instead Senior Care, U.S. Research Report, 40/70 Rule
- 34% of American adults are estimated to be conversation avoiders. That means they haven’t talked about any important end-of-life issues with their parents or children, or they have only talked about one issue.* Marist Poll
BETTER THREE HOURS TOO SOON THAN A MINUTE TOO LATE – William Shakespeare
Begin by acknowledging that this is a process. It’s not something to accomplish quickly.
Begin by knowing your loved ones might disagree with you, and that’s okay.
Begin by acknowledging that you will not be able to figure out every possible scenario. Keep to basics and generalities.
Begin by thinking about your own beliefs, philosophies, values and preferences today, and consider the future. Write those decisions down and add to them.
Begin by including loved ones in the planning and in conversations as soon as you are ready. There is no rush. The key is to know your own wishes first.
Begin by recalling end-of-life experiences with loved ones. Use personal memories to set the foundation for your own choices.
Begin by understanding that it is never too late to begin your bucket list.
Begin by thinking about the things you do and you don’t want at the end of your life.
Advance care planning is important to complete if you: (Mark all below that are true)
______ Have specific or unique healthcare preferences
______ Want to provide peace of mind to family members
______ Like to have a say in your healthcare decisions
______Want to live well, even through your own death
______Are living with serious, advanced illness
______ Are living with chronic illness, either potential or realized
______Have elderly family members living alone or in another country
If you said yes to any of the responses above, now is the time to begin the conversation about your end-of-life wishes.
FIVE WISHES from Aging with Dignity is a document that I have been talking about and using for many years in my previous practice of hospice and end of life nursing as well as personally now in my retirement with family, friends and colleagues. I cannot stress enough the importance of having these discussions with your loved ones. Consider this a gift that you give to them. Consider this a unique opportunity to have a very special conversation, as difficult as it may be. You will be forever grateful that you did.
Rozanne Lofaso Taylor Van Rie is a Registered Nurse from NYC, Boston and Washington, D.C.
After a long career in oncology nursing, she was tasked by a major MCO to develop an Oncology Case Management program that would assist the organization and the eldercare team with providing quality end-of-life care with planning and communication – partnering with physicians, patients and families alike.
HELPFUL LINKS for caring for your aging family’s health
AGING With Dignity
FIVE WISHES
The Conversation Guide for Families
https://fivewishes.org/shop/order/product/the-conversation-guide-for-individuals-families
The Checklist to Complete Long before You Need It by Robynne Pendariès
https://www.fawco.org/global-issues/health/health-articles/4413-the-checklist
National Institutes of Health: Caring for a Dying Relative
https://www.nia.nih.gov/health/where-can-i-find-care-dying-relative
Caregiving Topics
https://www.agingcare.com/topics
Elderly Care Plan questions
https://www.agingcare.com/topics/87/care-plan/questions
‟Mom is Refusing Care”
US Administration on Aging
https://eldercare.acl.gov/Public/Index.aspx
American Society on Aging (AARP)
https://www.aarp.org/caregiving/?intcmp=GLBNAV-SL-HF-CAR
Photo: Canva