The most important conversation we’re not having

Published 6:11 pm Friday, November 24, 2017

End-of-life decisions are probably the last thing you want to think about and discuss with your loved ones, especially during the holiday season. You may think to yourself, “I’m not sick” or “I’m too young,” but this conversation is important for adults of all ages. Advance-care planning is about planning and recording your health care choices in case you become seriously ill or injured and cannot express what you want. It’s about discussing what your wishes are while you are healthy and not in a crisis, so you can make clear decisions about your wishes and document them in your medical record so that those wishes can be honored.

Advance-care planning is for all adults, ages 18 and up, no matter the state of health. It’s important to note that it is a process, and you should take time to carefully consider what you would want in the event you become seriously ill or injured. This could include treatment decisions or special instructions. There are five steps to complete an advance-care plan, including thinking about, talking about, writing about, sharing and reviewing your plan.

The first step in advance-care planning is thinking about what matters most to you and how that might influence your choices about future health care decisions. It’s important to take your time during this process to consider what you would prefer to happen if you need medical care. It may be helpful to journal or talk with trusted loved ones, your doctor or pastor/clergy. A few things to consider might be reflecting on past experiences of loved ones who received medical treatment or who may have already died.

Once you have thought about your wishes, the next step is to talk about your thoughts with loved ones, your health care providers or anyone who might be involved in your future health care decisions. This can be a difficult conversation to start, as you might be fearful of how your loved ones may react. You will likely discuss this more than one time, and you and your loved ones will become more comfortable with each discussion. This is a very important and difficult step, as it can be very emotional for some people.

The third step in advance-care planning is to put your wishes in writing in a document called an advance directive. This gives your loved ones and health care providers the information they need to honor your choices. There are several different kinds of advance directives, some that you can complete and some that require your doctor to complete. Most common types of advance directives include health care power of attorney, living will, medical orders for the scope of treatment (MOST) or do not resuscitate order (DNR).

Once you have put your choices in writing and completed your document(s), the next step is to share copies of it with your health care provider(s) and your family/loved ones. Be sure to review your advance directives with them so that they know and understand your choices. It’s highly advised to have a copy of your advanced directives in your medical record at your local hospital, as well as at the office of your health care provider(s), and with your family and/or designated health care power of attorney. They need to have access to your advance directives and be able to find them should you become seriously injured or ill.

The last step in advance-care planning is to review your decisions periodically. Your thoughts and choices may change over time. It’s important to ensure your document(s) reflect your current preferences and that your health care agent is still your best choice. You should reexamine your document(s) when there are major changes in your life or at least once per year.

The best way to learn the details about these documents is to ask your health care provider or visit Click on the “Toolkit” link for more information about advance-care planning and to learn about events in the community. If you need more information or are interested in hosting or attending an advance-care planning event, please email or stop by Vidant Wellness Center for a toolkit and more information at 1375 Cowell Farm Road, Washington.

While advance-care planning is a process and can be difficult, it could be the best gift your loved ones receive this holiday season. Your loved ones will know and understand your wishes, and it will help ensure that your wishes will be honored in the future.

Meagan Overman, MS, CCEP, is a clinical exercise physiologist and certified advance-care planning facilitator at Vidant Beaufort Cardiovascular Rehabilitation in Washington. She can be reached at 252-975-4236.