Talking to Your Agent

It may not be an easy conversation to start, but those who make the effort to discuss the hard topic of what kind of medical care they want at the end of life usually find the effort worth the price. You'll probably want to begin by talking with your agent; then, if you can, discuss your feelings with close family members and friends as well. If the topic seems too difficult to broach, consider using a relevant news item, television show or film as a catalyst for discussion.

There are three basic goals when talking with your agent:

• making sure the person you've picked is willing to take on the responsibility of acting on your behalf
• sharing your written directions and other wishes, and
• allowing your agent to ask questions so you are both clear on what you want.

During your discussion, your agent may ask about issues you haven't considered. This is a great opportunity for each of you to clarify the understanding between you so that you both can feel confident that your agent will know what to do if he or she must represent you.

If you have a regular doctor, you may want to encourage your doctor and your agent to meet. If you are already a patient in a medical facility, your agent will also want to get to know the social worker or patient representative of the facility.

Why are these discussions so important? First, it gives you the opportunity to let people know that you are preparing health care documents, and why you feel strongly about doing so.

Second, it is impossible to foresee all of the circumstances or illnesses that may arise and address them in your documents. Giving people a clear understanding of your personal views and values can avoid future disagreements as to how your written desires should be applied to specific circumstances.

In discussing your values, you may want to cover some or all of the following:

• your overall attitude toward life, including what gives you feelings of purpose and meaning and how you feel about your independence
• fears you may have about no longer being able to speak for yourself or make your own decisions
• any strong feelings you have about medical treatments that you do or do not wish to receive at the end of your life, including life support and feeding tubes
• where you would prefer to be at the end of your life (for example, many people feel that they would rather die at home or in a hospice facility than in a hospital)
• what a phrase such as "death with dignity" or "no heroic measures" actually means to you
• anything you want others to know about the spiritual or religious part of your life and how it affects your feelings about serious illness and death
• hat you might want for comfort and support when you are close to death (for example, to have certain people present, to be read to or to have music playing)
• your feelings about doctors and caregivers, in general, as well as any opinions about specific caregivers, and
• what you want after your death, including feelings about organ donation, an autopsy and final arrangements (for example, burial, cremation or memorial ceremonies).

Obviously, these conversations are not always easy to initiate or carry out, but they present all involved with an opportunity for greater peace of mind. Your loved ones will know your true wishes, and you may find that this is not only a chance to gain clarity and understanding, but also a bridge to closer relationships.