Talking to Your Loved Ones About Your Advance Directives

The other day, we met with a family that wanted to update their wills, powers of attorney and advance directive. This was a couple in their 80s and their two adult children. As is customary in our office, we all sat around my conference room table and reviewed their current situation, their existing estate planning documents, and their wishes. As we were discussing the advance directive and the parents were expressing their treatment preferences and who they wanted to make their decisions, I asked a question that I ask most families, “Is this in line with what you have talked about before?” I like to use this question to bring up significant changes, uncover cognitive functioning issues, and offer the adult children an opportunity to ask clarifying questions.

After I asked the question, the son said, “We’ve never talked about any of this before. Mom and Dad made it clear that things were in place for ‘when the time comes,’ but they never shared any details.”

I cannot stress how important it is to talk to your loved ones about your advance directives. Completing and properly executing the form is really important, but you must also talk to your appointed agents and legal next of kin about your wishes. You cannot rely solely on the written document to effective communicate with your loved ones.

Five Important Topics

When talking  to your loved ones about your decisions, there are five important topics to cover: I have an advance directive, I have selected health care agents, I have thoughts about quality of life and life support, I have written down my treatment preferences, and I want to know your questions. We will go over each of these topics individually.

1. I have an advance directive.Your beautifully executed, fully updated document is of little use if no one knows it exists. The most important piece of information for you to share with your loved ones is that an advance directive exists. Show your loved ones the document. Let them know where you keep it. Share with them who else has copies.
2. I have selected health care agents. We have already covered why naming health care agents is so important.  Now you need to tell those agents that they have been named and let others know about them. In addition to your immediate family members, your closest friends and family should know who about your health care agents. You can share with them what a health care agents will be responsible for and to reassure them that agents are not responsible for your medical bills. They also don’t have legal responsibility for you and can resign as your agent at any time.
3. I have thoughts about quality of life and life support. Your loved ones can make good decisions for you, effectively advocate on your behalf, and honor your wishes if they know and understand what is important to you. Talk to them about what “quality of life” means to you and how you feel about life support. What seems unbearable to you may be acceptable to someone else. For some, a good death is being able to die in your own home, surrounded by loved ones–so they may elect to “Allow my natural death to occur.” For others, it is important to die after trying every option possible to live.  Dying in a hospital, hooked up to machines may be their preference, so they elected “Try to extend my life for as long as possible, using all medications, machines, or other medical procedures that in reasonable medical judgment could keep me alive,” in the advance directive. Tell your loved ones your wishes, your thoughts on end-of-life care, on death, and on life support.
4. I have written down my treatment preferences. Showing your loved ones your document and reviewing your treatment preferences makes this very real.  Letting them know that you have written down what you want and that your health care agent will have the final decision-making will let them know how this all works. Let them know what was not included in this document.
5. I want to know your questions. These conversations are so tough, and by this point, you likely just shared some really difficult-to-hear thoughts with people that love you and never want to think about something bad happening to you. Some people are good at these conversations. Most aren’t. At this point in the conversation, it’s good to pause and hear what questions your loved ones have. You may want to ask them, “What concerns do you have about what I’ve shared today? What’s unclear?”

Have you completed your advance directive? Does it need to be updated? Does anyone know that it exists? Have you had these important conversations with your loved ones?

To download the Georgia Advance Directive for Health Care, please visit the Downloadable Forms section of our website.

The advance directive for health care is just one part of the advance care planning. To learn more bout planning for your future, please click here  and here.