Planning for The End of Life

A Gift For Your Loved Ones

What is advanced care planning?

Advanced care planning is the process of thinking about and planning for healthcare decisions that may need to be made in the future. It involves discussing and documenting the patient’s wishes for their medical care and identifying a healthcare power of attorney or another decision-maker who can make healthcare decisions on the patient’s behalf if they cannot do so. Advanced care planning is integral to end-of-life care and can help ensure that a patient’s healthcare preferences and goals are respected and followed.

Advanced care planning may include the following:

  • Discussing the patient’s preferences for their medical care, including their views on treatments such as life support and pain management
  • Identifying a healthcare power of attorney or another decision-maker who can make healthcare decisions on the patient’s behalf if they are unable to do so
  • Completing advance care planning documents such as a living will or healthcare directive, which outline the patient’s healthcare preferences and decisions
  • Communicating the patient’s advanced care plan with their healthcare team and other relevant parties, such as their family and healthcare providers

Advanced care planning is a personal and individual process that may involve different steps and decisions depending on the patient’s preferences and circumstances. Therefore, it is vital for patients to communicate their wishes and preferences for their medical care to their healthcare team and other relevant parties and to make sure that their advanced care plan is well documented and readily available if needed.

How to discuss end of life planning?

End-of-life planning is a necessary process that involves discussing and making decisions about the care and support a person wants to receive at the end of their life. Here are a few tips for how to have a productive and meaningful conversation about end-of-life planning:

  1. Start the conversation early: It’s essential to have these conversations as early as possible before a crisis occurs. This can help ensure that the person’s wishes and preferences are respected and that their care is aligned with their values and goals.
  2. Choose a good time and place: Choose a time and place that is private and comfortable for the conversation. Make sure you have enough time to discuss everything and will not be interrupted.
  3. Be open and honest: Be open and honest about your thoughts and feelings, and encourage the person to do the same. Creating a safe and non-judgmental space where the person feels comfortable sharing their wishes and concerns is essential.
  4. Listen actively: It’s important to listen actively and to pay attention to what the person is saying. This means giving them your full attention, using nonverbal cues to show that you are listening, and asking questions to clarify their wishes and concerns.
  5. Involve others as needed: Depending on the person’s wishes and circumstances, it may be helpful to involve others in the conversation, such as a family member, friend, or healthcare professional. Make sure to get the person’s permission before involving anyone else.

End-of-life planning can be a complex and emotional process, but it is important to ensure that the person receives the care and support they want at the end of their life. By having open and honest conversations and involving others as needed, you can help ensure that the person’s wishes are respected and that their care is aligned with their values and goals.

What is a living will?

A living will is a document that outlines a person’s healthcare preferences and decisions in the event that they are unable to make their own decisions due to illness or incapacitation. A living will can be an important part of advanced care planning and help ensure that a person’s healthcare preferences and goals are respected and followed if they cannot communicate their wishes.

A living will typically include:

  • A statement of the person’s wishes for their medical care, including their views on treatments such as life support, pain management, and feeding tubes
  • A designation of a healthcare power of attorney or other decision-makers who can make healthcare decisions on the person’s behalf if they are unable to do so
  • Instructions for how the person’s healthcare preferences and decisions should be carried out
  • Any other relevant information or instructions that the person wants to include

A living will is typically a written document, but it may also be recorded or conveyed in other ways, such as through an audio or video recording. It is important to keep a copy of the living will where it can be easily accessed by the person’s healthcare team and other relevant parties.

It is important to note that a living will is not legally binding in all states and may only be enforceable in some circumstances. However, it can serve as a helpful guide and reference.

In Louisiana, what happens if I do not have a living will?

In Louisiana, if you do not have a living will (also known as a Declaration for a Natural Death), your healthcare providers and loved ones will make decisions about your care based on what they believe is in your best interests. They will consider your values, preferences, and goals to the extent that they are known and will try to make decisions that are consistent with your wishes.

Suppose you have not appointed a healthcare proxy or designated a decision-maker in writing. In that case, your healthcare providers and loved ones will follow the state’s laws on decision-making for incapacitated individuals. In Louisiana, the hierarchy for making healthcare decisions on behalf of an incapacitated individual is as follows:

  1. A person with a durable power of attorney for healthcare (also known as a healthcare proxy)
  2. The individual’s spouse
  3. An adult child of the individual
  4. A parent of the individual
  5. An adult sibling of the individual
  6. A close friend of the individual

If there is more than one person in a category, the healthcare providers and loved ones will try to reach a consensus on the best course of action. If they cannot come to a consensus, the healthcare providers will make the final decision.

It is important to note that having a living will or appointing a healthcare proxy can help ensure that your wishes are respected and carried out, even if you cannot communicate them directly. It can also help to avoid conflicts or misunderstandings among family members or loved ones about your healthcare decisions.

Should I include hospice care in my advanced care planning?

Advanced care planning is the process of thinking about and planning for healthcare decisions that may need to be made in the future. It involves discussing and documenting the patient’s wishes for their medical care and identifying a healthcare power of attorney or another decision-maker who can make healthcare decisions on the patient’s behalf if they cannot do so. Advanced care planning is an integral part of end-of-life care and can help ensure that a patient’s healthcare preferences and goals are respected and followed.

Advanced care planning may include:

  • Discussing the patient’s preferences for their medical care, including their views on treatments such as life support and pain management
  • Identifying a healthcare power of attorney or another decision-maker who can make healthcare decisions on the patient’s behalf if they are unable to do so
  • Completing advance care planning documents such as a living will or healthcare directive, which outline the patient’s healthcare preferences and decisions
  • Communicating the patient’s advanced care plan with their healthcare team and other relevant parties, such as their family and healthcare providers

Advanced care planning is a personal and individual process that may involve different steps and decisions depending on the patient’s preferences and circumstances. It is crucial for patients to communicate their wishes and preferences for their medical care to their healthcare team and other relevant parties and to make sure that their advanced care plan is documented and readily available if needed.

What is a healthcare proxy?

A healthcare proxy, also known as a durable power of attorney for healthcare or healthcare power of attorney, is a legal document that allows you to appoint someone you trust to make healthcare decisions on your behalf in the event that you are unable to make those decisions for yourself.

The person you appoint as your healthcare proxy is known as your healthcare agent or surrogate. You can choose anyone you trust to be your healthcare proxy as long as they are over the age of 18 and are willing to serve in this role. You can also appoint an alternate healthcare proxy if your first choice is unable or unwilling to act on your behalf.

In the healthcare proxy document, you can specify the healthcare decisions that your proxy is authorized to make on your behalf, such as medical treatment, medications, and end-of-life care. You can also specify any preferences or wishes that you have regarding your healthcare, such as your preferences for pain management or your desire to be kept comfortable, even if it means prolonging the dying process.

It is important to choose your healthcare proxy carefully and to have a clear and open conversation with them about your wishes and values. This can help ensure that your healthcare proxy understands your preferences and is able to make decisions that are consistent with your values and goals.

Why a healthcare proxy is important

Having a healthcare proxy is crucial because it allows you to plan for the possibility that you may become unable to make your own healthcare decisions due to illness, injury, or other factors. In addition, by appointing a healthcare proxy, you can ensure that your healthcare wishes will be respected and carried out, even if you are unable to communicate them directly.

A healthcare proxy can also help to avoid conflicts or misunderstandings among family members or loved ones about your healthcare decisions. By clearly stating your preferences in the healthcare proxy document and discussing them with your healthcare proxy, you can help to ensure that everyone is on the same page and that your wishes are respected.
In addition, a healthcare proxy can provide peace of mind to you and your loved ones by knowing there is a plan in place for making healthcare decisions on your behalf if necessary. It can also help reduce the burden on your loved ones of making difficult healthcare decisions on your behalf without clear guidance.

Overall, having a healthcare proxy is an integral part of advance care planning and can help ensure that your healthcare wishes are respected and carried out, even if you cannot communicate them directly.

How to choose a healthcare proxy

There are a few key factors to consider when choosing a healthcare proxy:

  1. Trustworthiness: Your healthcare proxy should be someone you trust to act in your best interests and to follow your wishes and preferences.
  2. Ability to make difficult decisions: Your healthcare proxy should be able to make difficult decisions on your behalf, even if they may not agree with your choices.
  3. Familiarity with your values and preferences: It can be helpful for your healthcare proxy to be familiar with your values, beliefs, and preferences regarding healthcare. This can help them to make decisions that are consistent with your goals and values.
  4. Availability: Your healthcare proxy should be able and willing to make decisions on your behalf when needed. It can be helpful to choose a proxy who is local or who can be reached easily in an emergency.
  5. Ability to communicate effectively: Your healthcare proxy should be able to communicate effectively with your healthcare providers and advocate for your needs and wishes.

     

It can also be helpful to choose an alternate healthcare proxy in case your first choice is unable or unwilling to serve in this role.

It is important to have a clear and open conversation with your potential healthcare proxy about your healthcare wishes and preferences. This can help to ensure that they understand your values and goals and are comfortable and willing to serve in this role.

A healthcare proxy can also help to avoid conflicts or misunderstandings among family members or loved ones about your healthcare decisions. By clearly stating your preferences in the healthcare proxy document and discussing them with your healthcare proxy, you can help to ensure that everyone is on the same page and that your wishes are respected.

In addition, a healthcare proxy can provide peace of mind to you and your loved ones by knowing there is a plan in place for making healthcare decisions on your behalf if necessary. It can also help to reduce the burden on your loved ones of having to make difficult healthcare decisions on your behalf without clear guidance.

Overall, having a healthcare proxy is an important part of advance care planning and can help to ensure that your healthcare wishes are respected and carried out, even if you are unable to communicate them directly.

The process of designating a healthcare proxy in Louisiana

In Louisiana, you can designate a healthcare proxy by completing a document called a “Declaration for a Natural Death,” also known as a “living will.” This document allows you to appoint someone you trust to make healthcare decisions on your behalf in the event that you are unable to make those decisions for yourself due to illness, injury, or other factors.

To designate a healthcare proxy in Louisiana, you will need to:

  1. Choose your healthcare proxy: You will need to choose a person you trust to be your healthcare proxy and to make healthcare decisions on your behalf. You can also select an alternate healthcare proxy in case your first choice is unable or unwilling to serve in this role.
  2. Complete the Declaration for a Natural Death: You will need to complete a Declaration for a Natural Death form, which is available from your healthcare provider or online. This form allows you to specify the types of healthcare decisions that your proxy is authorized to make on your behalf, as well as any preferences or wishes that you have regarding your healthcare.
  3. Have the form witnessed: You will need to have the Declaration for a Natural Death form witnessed by two people who are not related to you or to each other by blood or marriage.
  4. Keep a copy of the form: You should keep a copy of the completed Declaration for a Natural Death form in a safe and accessible place, such as with your other important legal documents. You should also give a copy to your healthcare proxy, your primary care physician, and any other healthcare providers you see regularly.

Choosing your healthcare proxy carefully and having a clear and open conversation with them about your wishes and values is important. This can help ensure that your healthcare proxy understands your preferences and is able to make decisions that are consistent with your values and goals.

Discussing end-of-life care with a loved one

Discussing end-of-life care with a family member or loved one can be a difficult and emotional conversation, but it is an integral part of advance care planning and can help to ensure that the family member’s wishes are respected and carried out. Here are some tips for having this conversation with a family member:

  1. Plan ahead: Consider the best time and place for the conversation, and make sure you have enough time to have a thoughtful and thorough discussion.
  2. Be open and honest: Explain to the family member why you are having the conversation and what it means to plan for end-of-life care. Be honest about your thoughts and feelings, and encourage the family member to share their thoughts and feelings as well.
  3. Listen and respect their opinions: The family member may have different ideas about what is important when it comes to end-of-life care. It is important to listen to their perspectives and respect their opinions, even if you disagree.
  4. Share your values and preferences: Talk to the family member about your values and preferences when it comes to end-of-life care, such as your preferences for pain management or your desire to be kept comfortable even if it means prolonging the dying process.
  5. Ask about their decisions: If the family member has made decisions about their end-of-life care, such as completing a living will or appointing a healthcare proxy, ask them about their reasons for these decisions.
  6. Seek support: If you or the family member are struggling with the conversation, consider seeking support from a trusted healthcare provider, counselor, or spiritual leader.

Remember that this conversation is about the family member’s values and preferences, and it is okay if you have different ideas about what is important. Have an open and honest conversation and ensure that the family member’s wishes are clearly communicated and respected.

Clarifying your desires if you become seriously ill

It is essential to have conversations about the care you want to receive if you become seriously ill, as these conversations can help to ensure that your wishes are respected and carried out. Here are some steps you can take to have these conversations:

  1. Reflect on your values and preferences: Take some time to think about your values and preferences when it comes to healthcare, such as your preferences for pain management or your desire to be kept comfortable, even if it means prolonging the dying process.
  2. Identify your decision-makers: Consider who you would want to make healthcare decisions on your behalf if you were unable to make them yourself. This may be a family member, friend, or healthcare proxy.
  3. Communicate your wishes: Share your values and preferences with your decision-makers and discuss your thoughts and feelings with them. It can also be helpful to put your wishes in writing, such as by completing a living will or appointing a healthcare proxy.
  4. Update your documents: Make sure that your advance care planning documents, such as your living will or healthcare power of attorney, are up to date and reflect your current wishes and preferences.
  5. Talk to your healthcare providers: Share your values and preferences with them, and ensure they have a copy of your advance care planning documents.

Remember that these conversations can be emotional and challenging, but they are vital to ensuring that your wishes are respected and carried out if you become seriously ill. 

Choosing A surrogate decision maker

A surrogate decision maker is a person who is designated to make decisions on behalf of someone else when they are unable to make decisions for themselves. This may be due to a variety of reasons, such as changes in the person’s level of consciousness, cognitive impairment, or physical disability.

If you are helping a patient choose a surrogate decision maker, here are some steps you can follow:

  1. Discuss the importance of having a surrogate decision maker: It is important to explain to the patient the importance of having a surrogate decision maker in place and to discuss the types of decisions that a surrogate may be asked to make on their behalf.
  2. Encourage the patient to consider their values and goals: It is important for the patient to consider their values and goals and to choose a surrogate who is aligned with these. This may involve discussing the patient’s wishes and preferences with them and helping them to identify a surrogate who will respect and honor these.
  3. Provide information about the patient’s options: It is important to provide the patient with information about their options for selecting a surrogate decision maker. This may include information about the different types of surrogates (e.g., family members, friends, healthcare proxies) and the legal requirements for appointing a surrogate.
  4. Assist with the selection process: You can assist the patient in the selection process by helping them to identify potential surrogates and by facilitating communication with these individuals. You can also provide support and guidance as the patient makes their decision.
  5. Document the patient’s decision: It is important to document the patient’s decision about their surrogate decision maker, including any wishes or preferences.

Talking about the care you want if you become seriously ill

It is essential to have conversations about the care you want to receive if you become seriously ill, as these conversations can help to ensure that your wishes are respected and carried out. Here are some steps you can take to have these conversations:

  1. Reflect on your values and preferences: Take some time to think about your values and preferences when it comes to healthcare, such as your preferences for pain management or your desire to be kept comfortable, even if it means prolonging the dying process.
  2. Identify your decision-makers: Consider who you would want to make healthcare decisions on your behalf if you were unable to make them yourself. This may be a family member, friend, or healthcare proxy.
  3. Communicate your wishes: Share your values and preferences with your decision-makers and discuss your thoughts and feelings with them. It can also be helpful to put your wishes in writing, such as by completing a living will or appointing a healthcare proxy.
  4. Update your documents: Make sure that your advance care planning documents, such as your living will or healthcare power of attorney, are up to date and reflect your current wishes and preferences.
  5. Talk to your healthcare providers: Share your values and preferences with your healthcare providers, and make sure they have a copy of your advance care planning documents.

     

Remember that these conversations can be emotional and challenging, but they are an important part of ensuring that your wishes are respected and carried out if you become seriously ill. It may be

Preparing for the end of life

Making advance funeral arrangements for yourself can help to reduce the burden on your loved ones and ensure that your wishes are respected when the time comes. Here are some steps you can take to make advance funeral arrangements for yourself:

  1. Research your options: Consider your preferences for the type of funeral or memorial service you would like, as well as your preferences for burial or cremation. Research your options and compare costs to help you make informed decisions.
  2. Make your wishes known: Share your preferences with your loved ones and ensure they know your funeral and burial plans. You may also want to consider putting your funeral and burial plans in writing, such as in a will or other legal document.
  3. Pre-pay for your funeral: Many funeral homes offer pre-payment options, which can help to reduce the financial burden on your loved ones and ensure that your funeral and burial plans are carried out as you wish.
  4. Consider purchasing a burial plot: If you prefer a burial, you may want to consider purchasing a burial plot in advance. This can help to ensure that you are buried in a location that is meaningful to you and can make the process easier for your loved ones.
  5. Keep your documents organized: Keep copies of your funeral and burial plans, as well as any relevant documents, in a safe and easily accessible location. You may consider giving copies to your loved ones or a trusted friend or advisor.

Remember that advance funeral planning is an integral part of advance care planning, and it can help to ensure that your wishes are respected and carried out when the time comes. It can also provide peace of mind to you and your loved ones by knowing a plan is in place.

Making advance funeral arrangements for yourself

Making advance funeral arrangements for yourself can help to reduce the burden on your loved ones and ensure that your wishes are respected when the time comes. Here are some steps you can take to make advance funeral arrangements for yourself:

  1. Research your options: Consider your preferences for the type of funeral or memorial service you would like, as well as your preferences for burial or cremation. Research your options and compare costs to help you make informed decisions.
  2. Make your wishes known: Share your preferences with your loved ones and make sure they are aware of your funeral and burial plans. You may also want to consider putting your funeral and burial plans in writing, such as in a will or other legal document.
  3. Pre-pay for your funeral: Many funeral homes offer pre-payment options, which can help to reduce the financial burden on your loved ones and ensure that your funeral and burial plans are carried out as you wish.
  4. Consider purchasing a burial plot: If you prefer burial, you may want to consider purchasing a burial plot in advance. This can help to ensure that you are buried in a location that is meaningful to you and can make the process easier for your loved ones.
  5. Keep your documents organized: Keep copies of your funeral and burial plans, as well as any relevant documents, in a safe and easily accessible location. You may want to consider giving copies to your loved ones or to a trusted friend or advisor.


Remember that advance funeral planning is an important part of advance care planning, and it can help to ensure that your wishes are respected and carried out when the time comes. It can also provide peace of mind to you and your loved ones by knowing that there is a plan in place.