By Susan Varnum, LICSW, APHSW-C
Hospice Care Services Supervisor

We prepare for every significant event in our lives. We plan our weddings and prepare for the birth of our children. We plan birthday parties, graduation parties, vacations, and the list goes on. When the event arrives, we feel grateful that we planned-ahead, packed what we needed and invited the people we wanted to share the experiences with us. Our final months and days should reflect the same thoughtful planning, preparation and communication that we’ve poured into all our preceding life events. Yet, most of us hesitate when it comes to planning for the end of our lives.

Talking about death and dying can be challenging; it may remind us of previous losses of loved ones and friends, and no one enjoys thinking about future losses or our own death. However, these losses can show us what matters most to us and how we want our ending to unfold. Doctor Atul Gawande’s book, Being Mortal: Medicine and What Matters in the End, asks, “If time becomes short, what is most important to you?” Answering this question for yourself is the first step in preparing for end of life.

When we have only a short time left, we will likely want to spend our time and energy focusing on what matters most, like spending time with family and friends. This is precisely why advanced planning is important: when we make our wishes known in advance, our loved ones, health care providers and others will not be forced to make difficult, last-minute decisions – they will already know what we want.

How – and where – to begin
Advance Directives are documents that inform your doctor and loved ones about the kind of health care you wish to receive, including legal documents about who serves as your healthcare proxy, should you not be able to make medical decisions for yourself. Advance Directives can and should- be revised as circumstances change; the general recommendation is to consider the ‘5Ds’ – Decade, Divorce, Diagnosis, Decline, Death – as reminders to review Advance Directives.

In addition to Advance Directives, it is wise to work with an attorney to complete financial and estate planning. This process will include nominating a person or people to serve as Durable Power of Attorney, which is a person who is legally empowered to make financial decisions on your behalf, and an Executor, who will manage your estate. It is important to choose a person (or people) you trust for these roles to ensure they act in accordance with your wishes.

The Conversation Project offers guidance on how to start the conversation about your wishes with the important people in your life, including your health care providers. The organization also offers information for those caring for loved ones with dementia and those caring for children with serious illnesses. Locally, home health and hospice agency Granite VNA offers free information and assistance with Advance Directives at its “Walk-in Wednesday” sessions at locations in Concord, Laconia, and Wolfeboro.

Knowing that your affairs are in order can bring great comfort to you and your loved ones and allow you to focus on what matters most during a highly emotional time. End-of-life planning is truly a gift to those we leave behind.