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Considering an Advance Directive takes some courage - but brings peace of mind for you and your family.

Considering an Advance Directive takes some courage - but brings peace of mind for you and your family.

Advance Care Planning - Staring Into the Abyss or Taking Back Control?

Considering an Advance Directive takes some courage - but brings peace of mind for you and your family.

When I’m helping people plan their future, they’re usually comfortable with thinking about how their assets should be divided after they are gone, and who should take care of their affairs if they ever lose the capacity to make decisions for themselves. But when we discuss whether to make an Advance Directive (or living will) the conversation can raise emotionally challenging issues.

Not an easy conversation.

Some people’s eyes well with tears; some people call me the next day, telling me they have lain awake half the night worrying. Profound emotional responses are wholly understandable, because considering an Advance Directive involves contemplating our own ageing and mortality in deeply personal terms, which can be an uncomfortable experience. It’s a taboo subject that takes some courage to address.

The American Model – Advance Care Planning

As a nation, we lag far behind the United States on this issue. 72% of Americans have made an Advance Directive - including Barack and Michelle Obama. That’s because, in the States, they don’t just think of this issue in terms of staring into the abyss, but have embraced the wider and more positive concept of Advance Care Planning. We in the UK are starting to follow suit.

To make an Advance Directive, there’s no denying that you do need to think about death. But that’s not all it’s about. An Advance Directive should state what medical treatment you want, or do not want, to receive, should you become incapacitated. As long as you can think and speak for yourself, your Advance Directive doesn't come into play, because you will be able to accept or refuse treatment for yourself as you see fit. But if you cannot think or speak for yourself, your Advance Directive will be legally binding.

Taking back control – and gaining peace of mind

Your Advance Directive is a powerful shield that enables you to maintain control over your most profound and personal wishes. For example, you may be uncomfortable about the idea of the infamous “Liverpool Care Pathway”; you may have a horror of being artificially kept alive beyond your time; or you may simply wish to make it clear that you want your comfort and dignity to be the paramount consideration at all times.

These are the kinds of issues you can address in an Advance Directive. By discussing your preferences with your family and documenting them in an Advance Directive, you can plan every aspect of the care you do and don’t wish to receive.

US studies show that Advance Directives make it more likely that people will receive the care they want and less likely that they will die in hospital.

By making an Advance Directive, you potentially save your family a great deal of heartache, as illustrated by American physician Dr David R Grube, who described his own experience like this:

“My mom paid a painful price for not completing an Advance Directive about her preferences for end-of-life medical care. She was an intelligent and organized woman who had everything in her and my dad's life planned out and written down … Ironically, she never discussed her end-of-life care goals with my father or her physician son (me), preferring to talk about “more pleasant subjects” … She died in hospice care after prolonged, unbearable and unnecessary suffering. It broke both my dad’s heart and mine.”

So although it’s not one of the “more pleasant subjects”, it’s worth thinking carefully about, and making your wishes legally binding, for your benefit and that if your family.

If you find this a difficult subject to contemplate, empathy, support and practical help is just a call or email away, just fill in the contact form below or give us a call on 0151 601 5399 – we’re here to help.

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