UNMH’s Advanced Life Planning Task Force takes the necessary steps to ensure people meet their end in comfort and piece of mind.
As far as proper preparation goes, there’s more to death than just dying, said Anne Simpson, M.D., director of the Institute for Ethics at UNM Health Sciences Center.
Dr. Simpson is a chief proponent of the institute’s Advanced Life Planning Task Force, an ad hoc committee devoted to spreading education on end-of-life matters.
“All of us alive are going to die, but how do you think about your life, planning for it and people you care for, and in particular if you’re at a point where you are not able to speak for yourself,” she said.
Naturally, some people may find it difficult to broach the topic of the impending loss of someone near to them, but for the sake of readiness, it’s important they do so, Simpson said.
“What makes it easier to talk about is helping people to think it through, and to recognize that if you don’t have those discussions, which can be difficult for some people, (though not all), if you don’t actually talk about it, no one knows how to think about what you might want,” she said.
Since there’s only so much a person can encapsulate in their writing, end-of-life planning goes beyond the mere drafting of an advance directive (i.e., a living will), Simpson said.
“So how do you get people to think about, and know, what has meaning to you?” she said.
Simpson said people have a tendency to “couch” these discussions in short-term, narrow end-of-life scenarios, but there are circumstances that might render a person effectively incapacitated for decades at a time; for example, those who struggle with dementia
“People feel guilty about placing someone in a long-term care facility,” she said.
Without delving into the conscious desires of a person in your care, family members run the risk of acting out of line with that person’s sincere wishes, Simpson said.
A classic example is that of younger generations making misguided sacrifices with benevolent intentions on behalf of someone who can no longer care, let alone think for themselves, she said.
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“Well, if you’ve had those discussions with people you care about, you might prefer that they place you in long-term care, where there’s a skillset, people trained to take care of you. As opposed to keeping your grandchildren out of school to take care of you,” Simpson said. “Because, you know, people would want their grandchildren to be educated; they want their children to provide for their families.”
We don’t discuss things we don’t understand, Simpson said.
“We don’t understand nursing homes, so we don’t talk about it and we say ‘I’ll never put you there.’ But part of it is having the conversation, learning to think about ‘How do I find out more information about long-term care facilities? How do I actually start to accept the fact that not one of us is going to leave here alive?’” she said.
This is a matter of helping people we care about feel comfortable with having those discussions, and it helps to have an appreciation for the stark reality that “we’re all going to die,” Simpson said.
In her time as a geriatrician, Simpson said patients shared life lessons, stories with her that they would have rather shared with family, but death, waiting in the wings, has a way of complicating things.
“I’m thinking ‘I wish their family could hear this,’” she said, “but their family didn’t know how to even articulate dying. And so they were not able to be there, not emotionally and physically.”
Regardless of age, people need to learn to speak for themselves while they have the cognitive capacity to do so, Simpson said, because although we consider life a prolonged period of time before our eventual death, life can be dangerous, and accidents happen.
Due to its unfamiliarity, many people also fail to consider particular state policy surrounding this issue, she said.
“In New Mexico, there’s the Uniform Health Care Decisions Act, which lists an order of surrogacy, order for a decision-maker, for you if you have not appointed someone,” Simpson said, “So as young as you may be, (young adults), there may be people you feel understand you more than others.”
It’s important that we encourage thoughtfulness and articulate discussion in all aspects of life, including death, she said.
“That’s the point. To get people talking.” Simpson said. “Having discussions (like) that can be tough, but once you start talking about it you’ll find that other people had wanted to talk about it but didn’t know how.”
People love making plans, especially when they get to share those plans with others, but the ultimate plan involves the inevitable, she said, and we should be just as willing to share.
“You’ll plan a vacation and tell everyone about it, but this is the ultimate vacation. None of us know when it’s going to happen, but it’s there, so be prepared.” she said, “It is the gift that keeps on giving.”
Johnny Vizcaino is a staff reporter at the Daily Lobo. Contact him at news@dailylobo.com or on Twitter @thedailyjohnnyv.
