Don’t Let the Boogeyman Get You! — Advance Care Planning for Careful People.

Most of us remember childhood nights being afraid of something lurking in our pitch black bedroom. Whether it turned out to be a coat dangling from a hanger, or the cat pawing something around under the bed, it was paralyzing.

About a quarter of adults in the US have been thoughtful about what to do if they’re very sick and vulnerable and can’t communicate. Fewer than that have completed effective advance directive documents.

Planning for contingencies is one thing; planning for unpredictable medical decisions under pressure is another. Not planning for either is a careless and costly mistake.

How are you going to know what questions to ask?

If you’re not going to get better, would you rather stay in a hospital or be at home? If you need heavy medication to stay out of pain, would you want to take it if you couldn’t communicate at all with the people around you? What’s the difference between keeping you alive and keeping your body alive? If you are unconscious and your future is uncertain, what’s going to freak your friends and family out the most?

You can download free simple documents off a hundred websites and you’ll get exactly what you pay for. I believe effective advance care planning includes (1) regular conversations with the people who will be involved in your care, (2) an understanding of how medical and emotional concerns can create complications in your decision-making, and (3) working with end-of-life professionals who will help you shape a thoughtful medical care plan that includes, but is not limited to, legal or medical advice.

Be very concrete about who you’re putting in charge but be very flexible about how your projections about medical goals can be interpreted. Making absolute statements can actually prevent you from getting the care you want. Someone who says unequivocably “Never keep me alive on life support equipment” may actually mean “If I’m never going to have a meaningful life again, don’t keep my body going.” In another situation, keeping you on life support equipment may be exactly what you want until your body can support itself again.

I have three inspiring things to say about planning well for the end of your life. It’s not morbid; it’s a relief. It’s not a darkened closet; it’s the lightbulb going on that opens up new ways to look at what’s the most important to you. It’s not a boogeyman; it’s Dad turning the light switch on and showing you the scariest thing is not knowing.



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I would  give Kim Mooney’s Advance Care Planning Workshop ten stars out of five. She provides materials that really make you think. She brought out nuances from her experiences of real-life situations that turned some of my initial choices on their heads. Without Kim’s workshop I would have written an Advance Directive that could have accomplished exactly the opposite of what I would have intended!      Fred C.

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