So here I am, 74 years old, having spent much of my professional life urging others to do some advance care planning, and especially to have important conversations with friends and family about what matters to them.

I guess it’s time for me to do the same. Feel free to use this as a reminder of what we’ve already talked about.

I am going to leave decisions about actual medical treatments to you…or to me, with your support, if I’m still decisionally capable. If it falls to you, consent to treatment ONLY if it is designed to sustain my comfort and quality of life.

If you’re faced with decisions on your own, here’s what matters to me, right now. As it changes, I promise to tell you. You have copies of my more “traditional” advance directive.

I’d like to participate in making decisions about my medical treatment and quality of life, so long as I am able. What that means is: if some untoward event occurs and I’m rendered decisionally incapable, and if the treating professionals say there’s a good chance I can come back and make my own decisions, feel free to stabilize me–give it a try. But if it becomes clear I won’t return to decisional capacity…keep me comfortable and don’t prolong my life. Period.

If you see there are things that bring me pleasure, go for it (food, music, sitting outdoors and enjoying the sights and sounds, listening to the surf should any be close by, enjoying my kitties or other furry creatures). If I reach a point where I’m agitated or distressed, more than not, don’t worry about whether to give me meds that seem to sedate me more than YOU might like. Sedation is fine. It’s ok. Music and pets are great, too.  Cheaper than meds, and virtually no unwanted side effects. Always give them a try. Again, don’t force me to eat or exercise or try to “improve” me…or do things that just keep me alive…unless you see a preponderance of good, quality days over bad ones. It’s subjective, I know. You’ll do just fine.

Perhaps the best reflection of how I feel is this letter, “Don’t Panic,” a letter to her family by Karen Boudreau, MD.

And thank you all, very much. You are a gift to me. I hope this is a gift to you.

 

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