We often read that we should have an End of Life Plan. For many of us, we are unaware of what End of Life Planning involves. I often considered it an overwhelming and emotionally challenging task. We often struggle to start, let alone know where we should start, as I know from my experience!
In this article, I will look at how using the 4 questions will provide you with the basics so you can;
- Simplify the process for you
- Focus on what you need to do as part of developing your End-of-Life plan
- Make you aware of the main areas you need to consider as part of your planning
- Motive you to continue and complete the process
- Appreciate the benefits of undertaking the planning process
Let’s discover how you can make your End of Life planning easier and less stressful by using our 4 questions.
Benefits for you in having an End of Life Plan
The following 4 questions will assist you to undertake this task much easier. It is often viewed as intimidating, complicated and often neglected.
1. What Do I Most Value About Being Alive?
2. What Do I Think about Dying?
3. What family issues must I consider when arranging my End-of-Life Plans?
4. Who Needs to Know about my End of Life Plans?
By you using these 4 questions, you will benefit in the following 7 ways that most of us never would consider.
From experience, I now appreciate how quickly life situations can change. The turmoil and stress occur when no or inadequate End of Life Planning is done. Your pre-planning will ensure your affairs will be in order.
- The questions will make the process much easier for you to start your End of Life Planning. Your answers to the questions will make you more focused. Enabling you to develop a plan to achieve what you would want.
- Your responses to the questions will simplify the whole End of Life Planning process. You will have time to research and contemplate the various options available to you. Including the impact these will have upon you and your loved ones.
- Appreciate the impact your decisions will have on your quality of life in the end. Including
– the type and amount of medical intervention.
– amount and location of care you wish to receive in your last days, also
– the type of funeral service and your wishes about burial or cremation.
- By using these questions, your answers will save you time and money. When you seek the services of various professionals, to document your wishes. Ensuring the various parts of your plan are legal and enforceable as you will already have a very detailed plan of what you would want organised. Thus, reducing the billable hours of your lawyer, accountant, and doctor.
- You will feel more at ease knowing that you have prepared for your inevitable death. As you would have researched and thought about your final wishes.
- With your End of Life Planning completed any decisions your family must make about your medical treatment or End of Life care will be much easier. As they will know what you would want to happen.
- This prior preparation will reduce the stress, worry and turmoil for your loved ones. At the very time when they would be in a highly emotional state or grieving your loss. They won’t be seconding guessing if they are making the right decisions. As you have provided guidance on what you wanted to occur.
The 4 Questions you need to answer to start your End of Life Planning
What many of us have trouble with when making our End of Life plans is how to start the process. It can become complex, as many aspects need to be thought about when making your plan. The plan will encompass various personal, legal, medical, and financial parts. These are necessary to meet various statutory requirements. Also, to ensure your wishes will be implemented.
The first question you need to ask yourself is:
Question 1 – What Do I Most Value About Being Alive?
Consider what you enjoy most about life itself. To help you focus on answering the questions, you can try asking yourself the following;
- What do I enjoy doing?
- What do I do that brings me immense pleasure and happiness?
- What activity gives me purpose in life?
Like being active, independent, or in other words,
- What does a “quality life” mean to you?
- What would you not want to sacrifice or give up even if the medical intervention could keep you from dying!
Alternatively, you could ask yourself the question from the reverse perspective being
- What activities that I am currently able to do would I not want to sacrifice or give up just to be able to stay alive.
Such as being
- permanently bedridden,
- dependent on a ventilator to keep you alive.
- you lost your independence and need assistance to do everything from showering to making a cup of coffee!
- Unable to recognize your family or be able to talk to them
Remember, there are no right or wrong answers. The answers to these questions are as diverse as there are people in this world. For many of us categorized as “baby boomers” we have already experienced the death of one or both of our parents.
This event, for me, reinforced the realization of the frailty of life. It forced me to confront my own pending mortality
It was the catalyst that launched me to better understand what End of Life planning involved. To ensure I put into place what my family would need to know and act on when my time to depart this world arrived.
Being aware of the type of medical treatments and outcomes for common illnesses such as
- brain injury,
- heart attack or
- catastrophic or multiple organ failure, etc. and
- any common family health issues that are likely to impact you.
Should be an important part of your End of Life Planning research. As you need to be knowledgeable about the chances of and degree of recovery. As this will affect your ability to live a life that would still satisfy you.
After thinking about your future health care, you will be able to make informed decisions. From this research, you may develop powerful feelings about certain medical treatments. In that, you may decide the type and amount of specific treatment you would be willing to receive or not. In certain circumstances. Including life-sustaining treatment that only keeps you alive but doesn’t improve your health.
Being aware of your preferences, you will be able to inform your family and caregivers. In the event, you could not take part in the decision-making process or speak on your own behalf. This is an important part of your End of Life plan. For example, if you were suffering from Alzheimer’s dementia or had to be placed into a medically induced coma.
Over 50% of seriously ill hospital patients would rather not be kept alive on life support. When there is little hope of significant recovery
Modern medicine can maintain life in many extreme situations. Yet, it does not appreciate what you would want out of life if you survived or the burden it places on you. It fails to consider the financial and emotional burden it can place on people.
If you fail to think about your future health care and put plans in place, you may end up suffering. You need to consider what is your minimum acceptable medical outcome? Will it be
- lying in a hospital bed unresponsive? Or
- on renal dialysis and unable to communicate to your loved ones with no chance of improvement!
You need to answer the important questions of How important is the quality of life for you compared to living longer? Your answer to this question will help in providing guidance on the amount of medical intervention you would be willing to receive.
Question 2 – What Do I Think about Dying?
Your End of Life Planning should include your attitude to death and dying. What are your views on death and dying? You may have strong religious or spiritual beliefs and would want these honoured.
Alternatively, you may want to break with your family or religious tradition. If you have not communicated your wishes to anyone, no one will know about your final wishes!
Contemplating your own mortality may make you want to document your thoughts. These may be about the life you lived or thoughts about death and dying. You can achieve this through a Legacy Letter or Ethical Will, documenting –
- your reflections about what is important to you,
- life experiences, or
- events that shaped your life
- lesson you have learned throughout your life,
- beliefs, hopes, dreams, values, and opinions,
- how you are mentally confronting your mortality, or
- blessing and forgiveness for others, and not leaving things unsaid to family and friends.
Legacy letters can provide guidance and information to future generations of the family. These are often the most cherished item you can leave someone. It can be liberating to let your loved ones know how you have come to terms with dying. It may assist those that you left behind to better understand your decisions.
A Legacy Letter, whether written or videoed is often an important part of your End of Life Planning.
Question 3 – What family issues must I consider when arranging my End-of-Life Plans?
Over our lifetime, we will experience a range of relationships. Including marriage, divorce, separation or becoming estranged from our children. Whereas some relationships have withered, others blossomed.
An essential part of your End of Life planning must include estate planning. It is also about who you would want to receive what proportion of your assets upon your death? As well as preserving the greatest amount of wealth possible for your intended beneficiaries.
Your legal Will should reflect who the most important people are in your life. This can ensure they will be financially looked after when you die. Especially, if you separated or there had been a death of a family member or a major life event.
Your Will sets out instructions for how assets and possessions are to be distributed. To whom and when they are to be dispersed after your death.
Failure to update a Will may not provide financial security for your current loved ones. Which you may mistakenly believe will be automatic after your death. Legally, this may not be the situation.
An example of one of the potential legal issues that arise relates to a former spouse. Their ability to still have a claim on your estate even though you have separated from but are not legally divorced! To learn more about the various reasons why a Will can be changed after your death is discussed in Your Will – Learn How to Avoid it Being Changed After Your Death!
Another example relates to the circumstance of appointing a trusted person to be your Enduring Power of Attorney. A person who can make decisions about your property and financial affairs if you become incapacitated or unable to speak for yourself.
Part of your End of Life Planning will be to nominate a person who could make medical treatment or healthcare decisions on your behalf as a Substitute decision make in your Advance Care Directive. Ideally, this would be up to date and reflect your current wishes and circumstances. Otherwise, the law will take precedence over your wishes and people not in your life could have a say!
This could be family members you don’t want to have a say in the medical decision-making aspect of your life. Therefore, you must make sure you have a Living Will or Advance Care Directive. A written legal document that sets out medical treatments you would and would not want to be used to keep you alive. The document will also list your preferences for the type of pain management or organ donation you would want.
These are the reasons you would need to reassess and review what you have legally documented. Never think that “well, I have taken care of that” as this attitude is going to fail you.
The last question you need to think about is
Question 4 – Who Needs to Know about my End of Life Plans?
Having End of Life conversations is another important part of your End of Life Planning. Although you may wish to avoid End of Life conversations due to fear and denial they are essential. Ensure your views about death and your final stages of life are known to your family or friends.
The people you propose to carry out your wishes can be family, friends, or professionals. The people that you entrust this responsibility with must be able and willing to act in your best interests. Skilled to handle the requirements you have delegated to them under your plan
Your reluctance to talk about death inhibits planning for End of Life care and may result in your End of Life wishes not being followed. (1) The failure of not having an End of Life Conversation before a medical crisis occurs affects everyone in your family.
It makes it impossible for your family to know exactly what your wishes would be regarding further treatment or palliative care options if you fail to discuss them. These should be the first people you decide to discuss your last wishes with. Your family will also be better prepared to handle your death if they are aware of your final wishes.
Remember at the End
Life-threatening illnesses or tragic events can occur at any time. I strongly encourage you to consider these questions before you start your End of Life plan.
So, ask yourself the 4 thought-provoking End of Life questions. The answers required will often need you to research and contemplate the findings. You need to decide what you want your quality of life to be like in the end.
How you would want to be treated now and once you have died. Make your decisions based on the information you obtain from various reputable sources. Think about what you would accept as the minimum quality of life or independence you would be happy to live with.
Once you decide, you will be able to list the range of medical interventions you would not want to be subjected to. Decide who you would want to advocate on your behalf if you could not because of a serious injury or illness.
Engage the services of professionals when seeking legal advice on estate planning and your Will.
Ensuring you have a Good Death is an all-encompassing term around choice and dignity. It also includes what you deem is important for your End-of-Life Care. (2) This includes:
- Being pain free at the end of your life
- Cared for at home
- Being treated with respect
- Not being a burden to others
- Having your various physical, personal, and spiritual concerns taken into account.
You owe it to yourself to investigate this today.
End of Life Planning References
- Inquiry into End Of Life Choices, Parliament of Victoria Legislative Council Legal and Social Issues Committee June 2016, ISBN 9781 925458 39 8
- Seymour JE, Kennedy S, Arthur A, Pollock P, Cox K, Kumar A, et al. Public attitudes to death, dying and bereavement: a systematic synthesis. Executive summary. 2009. www.nottingham.ac.uk/
Other Sources Referenced for End of Life Planning Article
- The Conversation Project Survey was conducted by Kelton Global 2018
- Broad, J., Gott, M., Hongsoo, K., Chen, H. and Connolly, M. (2013) ‘Where do people die? An international comparison of the percentage of deaths occurring in hospital and residential care settings in 45 populations, using published and available statistics’, International Journal of Public Health, 58, p 257-267
- Conversations – Creating Choice in End of Life Care, Australian Centre for Health Research (ACHR) 2016
- Start the Conversation, Australian Government Department of Health – 18 April 2019.
- Dying Well, Hal Swerissen and Stephen Duckett – Set 2014 Grattan Institute Report No, 2014-10 Sept 2014
- Advance Health Care Planning, Stanford Medicine- Palliative Care Centre of Excellence – website viewed10 Sept 2021
- Advance care planning: The importance of expressing your medical wishes Author: Ruthann Richter Published on April 17, 2020
Frequently Asked Questions
How to Start End of Life Planning?
The following 4 questions will assist you to undertake this task much easier.
1 What Do I Most Value About Being Alive?
2 What Do I Think about Dying?
3 What family issues must I consider when arranging my End-of-Life Plans?
4 Who Needs to Know about my End of Life Plans?
What Does End of Life Planning Involve?
End of Life Planning is a way to ensure your affairs are in order and your wishes are known to your family and loved ones. This is achieved through prior preparation. It involves you organising a number of other documents including –
– Living Will or Advance Care Directive
– Legacy Letter or Ethical Will
– Estate Planning including a Will, Power of Attorney, Substitute Decision Maker, Living Trust
– Funeral Plans