Advance Care Planning – Now is the time to start the conversation

By Stacy Yun, B.A.

As much as we hate to admit it, there may be a time when we are too ill to make our own medical decisions. Advance Care Planning (ACP) is a process that allows you to make decisions about health care ahead of time, in the event that a medical crisis renders you unable to make these choices in the future.

We often have trouble finding the right time or the right words to start the conversation about ACP. In fact, surveys of nearly 8,000 U.S. adults revealed that only 26.3% of the sample had completed advance directives, a legal document that spells out your medical preferences. Thinking about severe illness or the end of life can be anxiety-provoking and scary. Often we wait too long to start the conversation about ACP until we are diagnosed with an illness or we start seeing serious changes in our older parents.

The best time for the conversation is now, when you and your family members have time and the ability for discussion and reflection. You might start by referring to an article or podcast (see “Speaking of Psychology: Making Talking about Death Easier,” http://www.apa.org/research/action/speaking-of-psychology/talking-death.aspx), online video, or movie (such as “The Descendants”) related to ACP in a casual manner, perhaps over the dinner table. Another approach is to utilize medical checkups, sermons, lectures, and books as ways to broach the topic.

Most importantly, realize that ACP is a process. Multiple steps are involved, including: 1) thinking about what works best for you, consistent with your values and priorities, 2) articulating your preferences to family, friends, and doctors, 3) deciding whom you would like to be the substitute decision maker if you are no longer able to speak for yourself, 4) putting your health care wishes in writing through an advance directive (see http://www.agingwithdignity.org and other resources listed below), and 5) making multiple copies of the advance directive document for your loved ones, caregivers, and doctors. You do not need a lawyer to complete your advance directive and it does not expire, unless you replace it with a new one.

Your signature and signatures of two witnesses are sufficient for the document to be considered legal. Be prepared to have more than one discussion on the subject, as preferences may change over time and some family members might need longer to think and process their thoughts and feelings. It is okay to have disagreements and emotional reactions during these conversations. The topic is sensitive and difficult, and starting the dialogue is the hardest part for many people.

To learn more about ACP, visit the National Institute on Aging website (https://www.nia.nih.gov/health/caregiving/advance-care-planning) or National Hospice and Palliative Care Organization (https://www.nhpco.org/advance-care-planning). Caregiver support services also are available in the Pikes Peak region to help you and your family start planning for the future. The University of Colorado Colorado Springs (UCCS) Aging Center provides up to eight free group and/or individual caregiving therapy sessions, funded by the Pikes Peak Council of Governments Area Agency on Aging (PPACG AAA), which also has a Family Caregiver Support Center.  For more information, contact the Aging Center at 719-255-8002 or PPACG AAA at 719-471-2096.

 Stacy Yun, B.A., is a Clinical Geropsychology doctoral student at UCCS who is completing her practicum at the UCCS Aging Center. For more information, contact her at syun@uccs.edu or call the Aging Center at (719) 255-8002.

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