Of courage and conversations that matter

Conversations about end-of-life care are not easy, especially when you are healthy and loving life.

I am currently updating my living will and creating a Medical Orders for Scope of Treatment (MOST) with my primary care physician.

Last week I met with Shirley, my durable medical power of attorney (medical agent or proxy), who will make decisions for me when I cannot make decisions for myself. We talked about my favorite activities and what primary values inform my view of death and the possibility of an afterlife.

She wanted to know what my “breaking point” might be.

My breaking point is cognition. I believe I can enjoy life even if I have limited mobility or require the assistance of others for daily activities.

But if I am unable to communicate or am irreversibly cognitively impaired, I would probably lose my will to live. I say “probably” because I have worked with many people who discover they can find joy even when they are severely compromised.

We then discussed various treatments: cardio-pulmonary resuscitation (CPR), pacemakers, defibrillator, dialysis, intubation, feeding tubes and various medications that relieve anxiety and pain.

After my conversation with Shirley, I wrote a 500-word statement summarizing my wishes for my end-of-life care. I shared it with my husband who was sad but offered a few very good edits. We then met with Shirley to ensure that we were all in agreement and understood my intentions. I then downloaded the Colorado MOST form.

Because of our conversations, I feel fully equipped to discuss this topic with my doctor.

He will complete the MOST form for me so that I can indicate my choice between Full Treatment, Selective Treatment or Comfort-focused Treatment in an emergency situation. Completing the Medical Orders for Scope of Treatment will turn my legal and personal documents into medical orders that emergency practitioners can quickly comply with my wishes.

Finally, I will deliver a copy of my signed MOST form to my local hospital to be included in my records. I will also carry a signed MOST in my wallet next to my driver’s license.

It can feel overwhelming to approach the task of creating end-of-life documents. Fortunately, there are organizations who can support us in this task.

My two favorites are:

The Conversation Project that offers free guides to help you Start a Conversation, Select a Health Care Proxy, Talk with a Health Care Team, and figure out What Matters to Me.

CaringInfo has so much valuable information. Plus, you can download the unique MOST, POST or POLST forms for each state.

By the end of July, I will finish the updates of all my end-of-life documents. I will then make a note to update them again in 2027. I hope you will make a commitment to create or update your end-of-life documents.

Your loved ones will thank you if such documents are needed. – Kitty