While it is important to complete and sign an Advance Directive, it is even more important to have a good discussion with your health care agents so they clearly understand your wishes. Froedtert Hospital (my old stomping ground) has an excellent list of 25 questions to guide your thinking and discussion.
It is important to also think about
- Your starting health. A 38-year old parent of two small children has a different starting point and health desires than a 72-year-old with advanced idiopathic pulmonary fibrosis (a usually fatal chronic lung disease that is difficult to treat).
- A recognition that your health can turn on a dime. A healthy 70-year old can have a stroke that leaves him disabled and almost bed-ridden. The stroke likely changed his desired wishes, not on the day after the stroke when recovery is still possible, but rather after an acceptance that the disability is now permanent.
- An understanding that sometimes really good health care can only get you to a place where you are not going to either die or make even a tepid recovery.
- When would you like palliative or hospice care involved in your care. My personal preference is to involve—or at least consult— them early and often.
- What constitutes a meaningful life for you? I am not referring to “a return to family, friends, work, and societal good.” I am referring to those grayer edges of meaningful. This is a difficult question to ponder.
- How do you define a “good death.” Your good death. Sometimes it helps to start asking what is a bad or undesirable death. (We all pretty much agreement on a bad death.)
More later. Until then, have you completed and discussed your wishes and signed your Advance Directives? Have your children? Assuming they are adults, they should.