How to Prepare for Death: Healthcare Considerations

“When you prepare today for tomorrow, tomorrow doesn’t seem quite so scary.”

Dr. Pamela Prince Pyle

I have yet to meet a patient or his or her family that regrets the amount of time they spent preparing for the knowable and the unknowable. Yet, I have witnessed carnage from those who arrive at “death’s door” with no thought to the possibility of needing a plan. 

If the patient is able to make healthcare decisions, the complexity of those decisions is not always understood. Often, the patient is seen by unknown clinicians and time skips by in brief hospital visits while unasked questions form and are forgotten. 

The relationship of trust is crucial between patient and doctor and developed over time with those who the patient is familiar. However, trust can become extraneous in the hospital setting. Without trust, fear may reach monumental levels as decisions must be made. 

You cannot prepare for every eventual possibility; however, you can prepare for the most likely. Preparation takes time and help from friends, family, your faith community, and your trusted professionals. 

If you are unable to voice your wishes, those who will be your advocate, including your healthcare proxy, will benefit greatly from your well-prepared Advance Care Plan. 

Preparing now will give you autonomy at a time when it seems everyone other than you is speaking about you, for you, instead of you. Every moment you prepare now will be yours and your family’s reward one hundred-fold when it is needed.

The benefits of ACP for individuals, families and society at large are well documented. These include the following: 

• Higher rates of completion of advance directives (i.e., Living Will, Healthcare Power of Attorney, Combined Advance Directives)
• Increased likelihood that clinicians and families understand and comply with a patient’s wishes
• A reduction in hospitalization at the end of life 
• The receipt of less intensive treatments at the end of life
• Increase of hospice services
• Increased likelihood that a patient will die in his or her preferred place
• Higher satisfaction with the quality of care 
• Better family preparation on what to expect during the dying process
• Lower risk of stress, anxiety and depression in surviving relatives of deceased persons

There are many sources for Advance Care Planning, however, I have found the Five Wishes to be the most comprehensive and affordable. For the price of a fancy latte, you will have legal document with which to work. The site has guides for completing the document, however, discussing it with your family and your clinician is also important. 

There are many preparations beyond healthcare choices that you, we, all should consider in light of the unyielding certainty of death each of us faces. Regardless of health status, thoughtfully working through these preparations will get the business end of dying over early. When a time stamp has been placed on your life, and days are counted, you want to make each one count. 

Next week, we will discuss the other practical preparations needed to bring peace of mind for tomorrow and all the tomorrows that follow. Your family or those who love you will not fully realize the magnitude of this gift until they journey with you in dying and grieving.