September 11th this year was a sad reminder that it has been ten years since that tragic morning none of us will forget. We still remember where we were when we first learned about the unbelievable events that were occurring. This year on September 11th, many of us thought about the lost lives, heroic acts and the utter senselessness of war. Some of us participated in memorial services or relived the events of that day, watching stories about the lost heroes and their loved ones left behind to carry on with their loss. However, some of us may have avoided all such stories, finding it unbearable to relive, even ten years later. I have to admit that I am part of this latter group, reluctant to stop and feel. Maybe it’s because the memories are still so vivid, or maybe it’s because if I don’t think about it, it won’t hurt.
Planning for incapacity brings about a similar reluctance. We don’t like to think about it happening to us or to anyone close to us. Yet, the reality is that very few of us will be able to function without any assistance until one day, having reached a ripe old age, we go to sleep and pass away peacefully during the night. Chances are much greater that we will need assistance at some point, whether it is with managing our finances, or making healthcare decisions.
You may say, but I have Powers of Attorney for both financial and healthcare decision-making. I have named agents to be my surrogate decision-makers and they will assist me when necessary. Great! Now let me ask, do your agents know what to do if called on to speak for you? Do they know your values and what is most important to you? Would your agent know what you would want if only you could speak?
It is very important to have documents in place that give a trustworthy person legal authority to speak for us. But it is equally important to go a step further and discuss our wishes and preferences with our designated agents so they are equipped and confident that they can truly speak for us when we can’t. This is the harder part for those of us who may feel reluctance to think about, let alone discuss our end of life wishes.
Fortunately, there are a number of tools available to help reluctant people like me to communicate my wishes to my agents without necessarily having a deep, face-to-face discussion. (After all, if I say it out loud it must mean I too will die one day?) The Center for Practical Bioethics publishes a “Caring Conversations” workbook that guides an individual through a series of questions to write down their values and preferences that should provide guidance to the agent. Hospice of the Western Reserve offers a similar guide called “Courage in Conversation.” One of my favorite tools, however, is the Go Wish Game, created by the Coda Alliance. The game is a deck of cards that one can “play” with one’s agent. Each card has a value statement and sorting through the deck allows the players to identify and prioritize an individual’s values. There are many other helpful tools available, the important thing is to find a way to communicate that works for you.