How to Die Well

Most people don’t die quickly.

As much as I would rather die suddenly–while putting a smile on my wife’s face–the odds are that I will spend my last hours or days in a hospital, unable to make the decisions about my care.

Will I be doing my vegetable impression after a car accident, or be left unable to speak during a botched Viagra implanantation in my 90s?  I don’t know.

There is one thing I know about the end of my life.  I do not want to linger for months, blind and deaf, on a feeding tube.   I don’t want my family to spend the last few months of my life secretly ashamed of hoping for my burden to end.   I’d like my end to be quick enough that the emotions they are feeling aren’t a sad combination of guilt and relief, just sadness at my passing and happiness at having had me.

That’s the legacy I’d like.

The problem is making my wishes known.  If I’m lying in a hospital bed, asking to be allowed to die, they’ll consider me suicidal instead of rationally considering my request.  If I’m completely incapacitated, I won’t even be able to ask.

I can certainly make my wishes known beforehand, but how will my family be able to communicate my desires to the doctors in charge and how will they convince the doctor that they aren’t just after my currently imaginary millions?

That’s where a living will comes in.   A living will, also know as an advanced directive, is simply a formal document that explicitly states what you want to happen to you if you are too out of it to make your wishes known.

Aging With Dignity has put together an advanced directive called Five Wishes that meets the legal requirements for an advanced directive in 42 states.

The Five Wishes are:

1.  Who is going to make decisions for you, if you can’t?   For me, the obvious choice is my wife.  She appears to like me enough to want me around and love me enough to do what needs to be done, even if it’s difficult.  On the chance that we end up in the same car accidents, matching vegetables on a shelf, I’ve nominated my father for the unpleasantness.   I don’t think I’ve told him that, yet.

2.  What kind of treatment do you want, or want to refuse?  When my Grandpa was going, he made sure to have a Do Not Resuscitate order on file with the nursing home, the clinic, and the hospital.  He knew it was his time and didn’t want to drag it out.

3.  How comfortable do you want to be?   Do you want to be kept out of pain, at all costs, even if it means being drugged into oblivion most of the day?  Do you want a feeding tube, or would you rather only receive food and fluids if you are capable of taking them by mouth?

4.  How do you want to be treated?   Do you want to be allowed to die at home?   Do you want people to pray at your bedside, or keep their religious views to yourself?  Some people want to be left alone, while others are terrified of dying alone.   This wish also covers grooming.   Personally, if I soil myself, I’d like to get cleaned up as soon as possible.   I’ll have enough to deal with without smelling bad, too.

5.  What do you want your family to know?  This includes any funeral requests you have and whether you’d like to be cremated, buried, or both, but also goes beyond them.  Do you want your family to know that you love them?  You can also take this section to ask feuding family members to make peace or ask them to remember your better days, instead of the miserable few at the end.

The last 3 wishes are unique to the Five Wishes document, but they are excellent things to include.   The most important part of advanced directive is the advanced part.    You have the right to want whatever works for you, but your wishes don’t matter if nobody knows about them.

How about you? Do you have a living will?  Does your family know what you want to have happen if the worst happens?