PREPARING FOR END OF LIFE
During our Men’s Life group, Ross Brown MD., Tom Perkins and Barry Tait prepared this information to encourage families to share their end of life preferences with each other. This will ensure that each individual will be faithfully represented when no longer able to represent themselves and prevent their loved ones from having to make life and death decisions on their behalf.
HISTORICAL PERSPECTIVE
Prior to the Civil War, most deaths occurred at home and so end of life care was undertaken by family members. After the war, nursing as a profession began to emerge and an increasing number of hospitals were being built. Through the early 1900s the emphasis on care began to shift from relief of symptoms to curing the underlying disease. Gradually the greater number of deaths occurred in institutions rather than at home. End of life decisions, therefore, now involve medical personnel in addition to family members, hence the need for end of life directives. For more information: Historical perspective on end of life care.
I. COMMUNICATE YOUR WISHES
1. Sharing your feelings and preferences for end of life care with your family and making sure they understand your wishes regarding quality versus quantity of life is a crucial part of preparation.
2. A Living Will (sometimes called an “Advanced Directive”) is a written record of your desires and intentions concerning end of life decisions. Such a document gives family and caregivers confidence that they know your intentions and are able to follow them should you be unable to do so.
3. If you do not already have an Advanced Directive (Living Will), a good place to get started is to work through this online exercise here. And, as part of the preparation process, you will choose a “health care advocate” to speak for you in the event you are not able to speak for yourself. This person is usually a spouse or child but does not have to be so. To see a very thorough Advanced Directive that you can modify for yourself, download here.
4. After you are satisfied with how you have expressed your desires and intentions in your Advanced Directive (Living Will), it is crucial that you share it with your health care advocate and family. This important step allows you to clarify your desires and helps everyone feel more comfortable about your intentions should you ever become unable to communicate directly at any point in your care.
5. Distribute copies of these documents to appropriate recipients (hospital, EMT, advocate, family, etc.).
6. Make sure your document AND your verbal communication with family or advocate is up-to-date. Most of us change as we age and it is normal as well as important to review and if necessary update our end of life preferences.
Faithfulness to what you believe is always important and never more so than when we approach end of life decisions. It may be valuable for you to discuss topics of concern with other members of your faith community or with your pastor or spiritual leader. Additionally, reviewing United Methodist doctrinal considerations may provide helpful guidance, though your faith is ultimately what you believe. Your faith is not dependent on ecclesiastical documents.
The United Methodist Book of Resolutions states:
“As human interventions, medical technologies are only justified by the help that they can give. Their use requires responsible judgment about when life-sustaining treatments truly support the goals of life, and when they have reached their limits. There is no moral or religious obligation to use them when the burdens they impose outweigh the benefits they offer, or when the use of medical technology only extends the process of dying. Therefore, families should have the liberty to discontinue treatments when they cease to be of benefit to the dying person. However, the withholding or withdrawing of life sustaining interventions should not be confused with abandoning the dying or ceasing to provide care.
“If death is deliberately sought as the means to relieve suffering, that must be understood as direct and intentional taking of life. The United Methodist tradition opposes the taking of life as an offense against God’s sole dominion over life, and an abandonment of hope and humility before God.” (Book of Resolutions, 2012)
Sharing your ideas and desires concerning your choice of pastoral care and memorial services can provide considerable comfort to you and your loved ones.
At some point, and it may be sooner than you anticipate, you or a loved one may suffer a calamity that plunges you deep into the murky waters of critical health care or end-of-life decision making. You will need all the help you can get, and you should be asking the question, “When and how can Hospice help make this journey a little easier?” When this happens, (or, before it happens if at all possible) we recommend that you consider the following:
III. Engage Hospice
Consider questions for Hospice personnel that pertain to your particular situation or condition.
We heartily recommend that you read through the Hospice Guide here that is in PDF format to give you the basics of what you need to know about Hospice. But then, if you are like us, you will still have a truck-load of questions and the website here is the best we have found for answering more of your questions.
The links we have listed in the above paragraph present a comprehensive (national) view of Hospice. After you familiarize yourself with this “bigger picture,” we also recommend that you get to know Hospice in your own local community. These people and these organizations can be a vital, life-saving part of your team. The better you know them, the more likely you will feel comfortable using their services.
For local Hospice providers in Kentucky go to: http://www.kahpc.org/HospiceProvider.
Central Office. 208 Kidd Drive Berea, KY 40403 (859) 986-1500 (800) 806-5492.
Compassionate Care Center. 350 Isaacs Lane Richmond, KY 40475
Also check out Bluegrass Care Navigators Fayette:
IV. Summary of information you need to leave for your family:
1. Your end of life advanced directives (Living Will).
2. Your desires for spiritual/pastoral care.
3. Your desires/suggestions for a memorial service/funeral and for attention to your remains (burial/cremation/other).
4. Your Last Will and Testament and perhaps a “Letter of Instruction” with other pertinent administrative instructions or desires.
FINAL NOTES:
You would not dream of driving your vehicle without insurance. Similarly, if you have neglected to prepare the above documents/information for your family or loved ones, please procrastinate no longer.
More in depth information on End of Life maters will be posted shortly.
Disclaimer — We are part of your church family, and our only desire is to sincerely guide you concerning some aspects of preparedness which often get neglected or postponed.
We further hope to edit and/or expand this information in the months ahead and would appreciate any feedback you wish to provide.