22 | APRIL 7 • 2022 

OUR COMMUNITY

W

e look forward to having many 
life cycle conversations with our 
families … about the person 
we’ve fallen in love with, about what we 
might name the baby (G-d willing) or what 
our retirement plans might 
look like. But there is one life 
cycle conversation we do not 
look forward to having … 
the one about our wishes for 
care near the end of life. 
Despite the fact that this 
is a vital and straightforward 
conversation to have, most 
of us would be hard pressed to think of 
a more uncomfortable topic to bring up. 
And if we summon up the courage to talk 
about it, our children or partners may 
not be in a place to hear it. But I have sat 
with too many adult children, poring over 
power of attorney documents trying des-
perately to understand what their parents 
would have wanted at that moment to not 
push the issue.
The Advance Care Planning process 
gives each of us the opportunity to have 
a voice in decisions made about our care 
should we ever be unable to speak for our-
selves. This includes deciding what types 
of care we want and what types of inter-
ventions we do not want. 
It also invites us to think about more 
subtle issues such as whether or not we 
want family to gather, if we would like a 
pet therapy visit while in the hospital or 
if we would like a certain type of music 

playing. Hopefully I’ve already covered the 
“why” it’s important to have this conversa-
tion and put it in writing. Now let’s turn to 
the Who, What, When and How.

WHO
An important part of the process is decid-
ing who will carry out your wishes. In 
Michigan, this is called your patient advo-
cate. Most likely choices include a spouse 
or partner, adult child or friend. Points 
to consider as you ponder your options 
include:
• How does this person respond to 
stressful situations?
• How often are you in contact with 
them as your wishes may change over 
time? 
• Will this person be able to carry out 
your wishes even if they don’t agree with 
them? 

WHAT
You’ll need papers stating your clear wish-
es for end-of-life care. It can be confusing 
because these documents can be referred 
to as a Patient Advocate Designation, 
Health Care Power of Attorney, Health 
Care Proxy or Medical Power of Attorney, 
but regardless of the name, the content 

and intent is the same. An attorney can 
draft them, or you can download a form to 
complete on your own.

WHEN 
The best time to start the conversation is 
before a health crisis occurs, when every-
one is thinking clearly and able to talk 
openly. Holiday gatherings ironically end 
up being the perfect time as families’ mem-
bers are usually in the same place. April 
16 is National Health Care Decision Day, 
which coincides with Passover this year. 
This might provide the perfect opportunity 
to start the conversation.

HOW
Many people start this conversation by 
referencing a plot line on a TV show or 
book where a main character passes away 
or struggles with illness or reference a 
related news event. Others suggest starting 
the conversation after processing through 
a loss saying something along the lines 
of “I’ve been thinking about how diffi-
cult it was to know how best to honor 
your Mom’s wishes last year and think we 
should talk about what we want.” 

WHERE
Once completed and signed (because, in 
Michigan, a patient advocate must sign 
that they accept this responsibility), give 
copies of your documents to your physi-
cians and hospital (where the information 
can be added into your medical record), 
and keep a copy at home in a safe place 
where family and your patient advocate 
can access it if needed.
One final thought: Be as specific as you 
can with your wishes, and update the doc-
uments as needed. This is not a one-and-
done conversation. For example, someone 
might draft that they do not want heroic 
measures taken if there is no chance of a 
good quality of life. What does “quality of 
life” mean to you? It might mean some-
thing very different at 55 then at 85, and 
the choices we make today may be very 
different from the choices we might make 
10 years from now. 

Lynn Breuer, LMSW, CDP, is the Senior Director of 

Community Outreach & Wellness at Jewish Family 

Service, overseeing the health coaching and cogni-

tive fitness programs. She is also adjunct faculty at 

Madonna University School of Social Work.

Lynn Breuer

Resources FOR HELP

• https://fivewishes.org/
• https://theconversationproject.org/ 
• https://www.michbar.org/public_
resources/probate_pad

How to make a difficult conversation a little easier.

Advance 
Care Planning 

JFS ST. PAUL

