Your Health

Giving Thanks For Some Means Getting Ready For Life's End

If things get slow around the Thanksgiving table, you might consider bringing up the tough topic of what everyone wants done about their care at the end of life.

A bunch of folks interested in advance directives and palliative care are encouraging families to make the talk part of their regular holiday plans. One way to get started is a five-question guide put together by a grassroots group called Engage with Grace.

Five questions to help write plans for the end of life. i
Five questions to help write plans for the end of life.

We chatted with Dr. Gail Austin Cooney, a palliative medicine specialist at Hospice of Palm Beach County in West Palm Beach, Fla., about how and why to have that talk. Cooney, 57, is president American Academy of Hospice and Palliative Medicine, but she also dealt with her own end-of-life planning in the last year, after being diagnosed with ovarian cancer.

Here's are edited highlights of our conversation.

Why would people want to bring up such a difficult subject at such a festive time?
Families are together. But there's less going on at Thanksgiving than Christmas or Hannukah. It's a time when people are thinking about what they're grateful or thankful for. That segueways nicely to what people's goals and expectations are for their health care. That's really what advance care-planning is about. It's looking down the road at places where we don't want to be.

How did your personal experience shape your views?
I was diagnosed with ovarian cancer in 2008. I saw the doctor Monday and had surgery Wednesday. Despite the fact that I've been practicing in the field for two decades, I didn't have an advance directive.

I was in the pre-op holding area trying to fill out an advance directive before they gave me the sedative. It wasn't difficult for me to do, but it is not the way to do it. It's an example of how things happen when we least expect them.

So what should people be talking about?
If something happened now, this is what I want. Things can change. These are discussions to have repeatedly over time because things change.

Living wills are what people pop to first. And depending on what state you live in, there are different requirements.[See the Web site palliativedoctors.org for help.]

And, if I can't speak for myself, who can I get to speak for me? It doesn't have to be next of kin, but it should be someone you trust to stand up for what you want. I'm the surrogate for some elderly friends of mine because they don't want to burden their children.

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