After The Golden Years

By Jennifer Cooke, D.O. –

Golden AgeAs we go through life, we make plans and set out our future goals, but not many people ever plan for what happens at the end of our lives. What are your last wishes when it comes to you health and end of life decisions? Have you discussed your plans with family members? Is everyone on the same page as you are? Do you have an Advanced Directive or a living will? Who will be making your decisions for you in the event that you can’t speak for yourself? What do you want to be done to/for you? Where will your funeral arrangements be made? Where will you be buried? How will these affairs be paid for?

All of these questions are very difficult to think about, let alone discuss and prepare for. In the words of John Lennon, “No mind can comprehend the infinite and absolute.” It is very frightening to think about one’s own mortality. Logically, we are all aware that the end is coming, but emotionally it is very hard to wrap our minds around this fact, and therefore these conversations oftentimes never take place.

Many of you have lost loved ones along the journey of life, and as you know, the responsibility of those end of life decisions and final arrangements are most often placed on grieving spouses, children, siblings and friends. Having a plan ahead of time allows peace of mind for both you and your loved ones. This plan consists of having a conversation with your family members and friends about what your preferences are regarding your healthcare.

Most people will have these preferences documented in a living will or other type of legal document serving the same purpose. In addition, you will choose someone whom you trust and know will carry out your wishes when you are no longer able to make your own decisions regarding your healthcare. This person is called your healthcare proxy or (durable) healthcare power of attorney. This spokesperson is different from a financial power of attorney, however the same person may be chosen for both purposes if you wish.

One way to go about creating an advanced directive is to meet with an attorney, however in most states this is not required. Many states or agencies for the aging have simple forms that can be completed online. At, you can find the “Five Wishes” form that satisfies the requirements for a living will/advanced directive in 42 states and the District of Columbia, (including Florida), and is available in 26 languages. The first of the “Five Wishes” is where you disclose your healthcare power of attorney. The second wish discloses your preferences on what medical treatment is to be done, or not done. Wishes three and four deal with comfort and how you should be treated at the end of your life. The final wish allows you to tell your loved ones information about yourself including your wishes for your funeral arrangements.

In addition to alleviating the burden on your loved ones, who would otherwise be making these decisions for you, having an advanced directive/living will significantly reduces healthcare costs. According to the CDC, “More than 25% of all Medicare expenditures are for care during the last year of life…despite that many Americans have expressed preferences for ‘no heroic measures’ when faced with a terminal condition.” One of the reasons for this is because loved ones are afraid to make the wrong decisions, however, if there is a living will/advanced directive in place, there is no question what your wishes are, and those decisions will be made correctly. Sadly, this number is only set to increase as our Baby Boomer generation continues to age. For more information, you can visit to learn more about Advanced Care Planning.

HarborSide Internal Medicine

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