April 16 is National Healthcare Decisions Day.
We're not talking insurance plans, reproductive rights, exercise routines or nutrition.
We're talking death — one of the most important decisions you'll have to make for yourself, your parents, your grandparents, perhaps others.
- Who do you want responsible for making decisions for you in case you're ill?
- What kind of care do you want to receive? Do you want aggressive treatments to prolong life or palliative care to provide comfort measures, increasing the quality of life in your final days?
- What do you want to happen to your body after you pass away?
These are all tough questions, but they're important ones.
It turns out that one out of every four Medicare dollars is spent on treatment during the last year of life. If we're spending that much money, we should be investing an equal amount of time and thought into seriously talking about this time period with our loved ones.
National Healthcare Decisions Day encourages people to fill out an advance directive. This legal form outlines answers to many of the above questions, ensuring your end of life wishes are upheld once you're unable to communicate them. (You might have heard of a living will — same idea.)
There's this push to "have the conversation" with your older relatives -- and I'm all for that. In fact, next weekend I'm setting up a Skype date with my parents so we can fill out their advance directives together. (If you want to do something similar, download the necessary forms. I personally recommend Five Wishes or your state's own advance directive form.)
It's not only about about having your end of life wishes in legal writing; it's about having the courage to talk about death now, when things are seemingly okay, when you can make measured decisions with plenty of time to think about them. You can always modify the form later. But filling it out now, however old you are, is — in a way — being brave enough to face yourself and your ultimate priorities. It's about realizing what's important to you and why.
To underscore this point, here's excerpt from Atul Gawande's moving essay "Letting Go," in The New Yorker. Here, he's speaking with Dr. Susan Block, a palliative care specialist:
“A large part of the task is helping people negotiate the overwhelming anxiety—anxiety about death, anxiety about suffering, anxiety about loved ones, anxiety about finances,” she explained. “There are many worries and real terrors.” No one conversation can address them all. Arriving at an acceptance of one’s mortality and a clear understanding of the limits and the possibilities of medicine is a process, not an epiphany.
This program aired on April 16, 2012. The audio for this program is not available.