Tools available to facilitate ‘the talk’


Last month, I emphasized the need for planning during the third phase of our life. A very important part of end-of-life planning is starting the conversation with the ones you love.

Five Wishes and Prepare for Your Care offer tools that can help. They address personal, medical, spiritual and legal wishes in a way that facilitates the discussion with loved ones and caregivers. You want these people to know exactly what you want and not have to guess.

Both tools help develop documents that meet the legal requirements for advance health care directives in Arizona, too.

A bit of a warning about advance directives. Without discussion and participation with your family, they might not provide a complete picture as check-marked decisions don’t always fit real-life medical scenarios.

For example, COVID-19 treatment might require the use of an incubator to assist your lungs. Choices in your advance directive might preclude such a treatment. If you discussed the choices with your family, they might have a better understanding of the context in which your choice was made. A written narrative may be useful as an addendum to a prepared advanced directive.

When preparing advance directive documentation, consider:

  • Identifying who you want to be your health care proxy – someone you trust to fulfill your choices. They should share your views and values, be able to respond quickly and meet any legal requirements established by the state.
  • Establishing a backup proxy should your first choice be unable to serve.
  • Appointing a legal/financial agent to manage your will and finances.
  • Speaking with your medical team to better understand the implications of your medical choices.
  • Completing Medical Orders for Life-Sustaining Treatment and Physician Orders for Life-Sustaining Treatment forms for additional clarity.
  • Making multiple copies of your documents and storing them where they can easily be found by your proxy. Advance directive documents can also be stored in the Arizona Healthcare Directives Registry.
  • Periodically reviewing and updating your documents.

As humans, we are remarkably good at making decisions and handling adversity. We usually have a good idea of our values and what gives our life meaning. Sudden illness or incapacitation can cloud that process. Hence the importance of documenting in advance.

Take your time to help confront difficult questions, such as:

  • How long do I want to continue medical treatment in the face of terminal illness?
  • How long do I want to continue treatment in the face of dementia?
  • Am I willing to lose a critical ability (to walk, speak, eat, etc.) and continue living?
  • When do I want to begin palliative care?
  • Do I want to donate my organs?
  • Do I need to have all family members in agreement with my decisions?

How do my spiritual beliefs play a part in my decisions?
Once you have had time to consider your thoughts, gather your family and use an attorney or one of the available advance directive tools and have “the talk.”

Source: NCOA Aging Mastery Playbook, Firman & Stiles, p. 83


Ron Smith is an aging-in-place advocate, a Certified Aging-in-Place Specialist (CAPS) and a Certified Living in Place Professional (CLIPP).,