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Give peace of mind to those you love by making wishes about life-sustaining matters via advance directives

Margie and Don, a couple in their 80s, are living quite happily in their central Pennsylvania home of 50 years. They manage their own financial affairs, attend church, and enjoy frequent visits from their children and grandchildren. Margie and Don sleep well at night knowing that, should an illness or injury leave one or both of them unable to make decisions, their children will not have the burden of trying to guess what those decisions might have been.

The couple have given their children the gift of advance planning. It is a thoughtful gesture that can eliminate uncertainty, speculation, and discord within their family, and make it easier for their healthcare providers to honor their wishes.

The Pennsylvania couple has prepared, signed, and let their children know the location of documents known as "advance directives." These documents include a living will and a power of attorney for healthcare. Margie's and Don's advance directives communicate their wishes on issues including:

• The kinds of medical treatments they want and do not want to extend or sustain life in terminal conditions.

• The person(s) designated to make decisions for each of them and for both of them if they are hurt in the same accident.

• The kinds of comfort care they desire, such as measures to reduce pain and suffering.

• Preferences based on their religion.

Following the example of a neighbor whose children benefited from such planning, Margie and Don broached the subject of their advance directives with their family members in a positive light. Reluctant and resistant to the conversation at first, their sons and daughters understood that their parents wanted the discussion as much for their own peace of mind as for their children's benefit. Once on board, the children were grateful and relieved. They knew that if they ever needed to make decisions for their parents, they would not have to wonder if they were doing "the right thing."

Planning

Advance planning is the best way to prepare for difficult decisions. Knowing that financial, legal, and healthcare preferences have been expressed can alleviate stress during difficult times. Several issues should be carefully considered in advance care planning.

• Preferences. It is important for people to make their preferences known and clear to their family members, doctors, and others around them. These preferences include medical directives, which may

be communicated by assigning power of attorney for medical decisions and/or creating a living will.

Preferences also include desires and requests related to funeral and memorial services.

• Financial and Legal Documents. Creating a will can ensure that an individual's specific desires for the distribution of his estate will be carried out. All important information related to bank accounts, IRAs, stocks, loans, and financial commitments should be made available to a designated family member, friend, attorney, or other person who will serve as executor of the estate. Additional legal documents, such as birth certificates and marriage licenses, should also be made available.

• Help with Planning. Many different kinds of professionals can assist in creating the advance directives that help ensure an individual's wishes will be respected. Lawyers and members of the clergy are obvious examples. Some counselors and social workers—especially those who work for hospice services— are uniquely qualified to offer guidance at all stages of the advance care planning process. Hospice professionals can answer questions about what to expect, provide support for sensitive conversations with friends and family, and provide help in dealing with sadness, grief, and other complex feelings.

Additional Resources

• The U.S. Administration on Aging Web site at www.aoa.gov has links to end-of-life resources.

• The National Hospice and Palliative Care Organization Helpline can be reached by calling 1–800–658–8898 or visiting their website at www.nhpco.org.

• Several excellent publications in the Complete Life series, developed under a grant from the Administration on Aging, are available online from the University of Hawaii's Center on Aging at www.hawaii.edu/aging.

As the Nation celebrates Older Americans Month in May, you can learn more about advance care planning and other topics by visiting www.aoa.gov. The theme of Older Americans Month—"Celebrate Long-Term Living!"— highlights the goal of organizations throughout the Aging Network to help older Americans stay healthy and active longer. For information about local resources, contact the Eldercare Locator at 1–800–677–1116, or visit www.eldercare.gov.

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