The Next Steps: How to Start Your End-of-Life 'Conversation'

Helpful resources to get you and your family prepared for the future.

ByDR. SHARI BARNETT, ABC News Medical Unit
August 15, 2012, 6:49 PM

Aug. 16, 2012— -- You have started to think about what you would want for the end of your life, but where should you start?

Fortunately, there are several resources to which you can refer to help you start your own conversation, including those that will help you decide what questions you should ask yourself and what choices you or your family will be faced with at the end of life.

Initiate the Conversation

The Caring Conversations Workbook, published by the Center for Practical Bioethics, is a great place to start. This workbook will help you ask yourself questions that will be important for your decision-making process. It will help you explore your feelings about certain scenarios and provide you a place to start collecting your thoughts.

Another resource, produced by the American Bar Association, is its Tool kit for health care advanced planning. This collection of 10 simple tools to help you and your family have an end-of-life conversation can also help you explore, refine and voice what is important to you at the end of life.

Get Your Documents in Order

These resources can help get you started in preparing the documents you need to secure your end-of-life plans.

There are three major terms you should know when you are trying to communicate your wishes to your loved ones and your health care team.

Advanced directive: It refers to any document that gives instructions about your health care. Your advanced directive is often made up of a living will and durable power of attorney for health care.

Living Will: Your living will is the section of your advance directive that states your wishes regarding the medical treatments you would want if you were terminally ill, permanently unconscious or in the end-stage of a fatal illness.

Durable Power of Attorney of Health Care (or Health Care Proxy): Your durable power of attorney for health care is person (or proxy) who will make medical decisions for you if you can no longer make them for yourself. You should give the proxy instructions for how to make these medical decisions in your living will and also discuss these topics with all of your loved ones, but especially your proxy. Your proxy is supposed to communicate to the health care team what you would want in the event you can no longer do so.

Choices like these can be demanding on not just person who is setting up the living will but also on the family member or friend who will be called on to act as a health care proxy or agent.

Act as a Health Care Proxy or Agent

There are resources for the health care proxy or agent, as well. The American Bar Association has produced guide on how to serve as an effective advocate for a loved one.

Start the Process Online

There are many resources to help you establish an advance directive online. ( can also help you establish a Web-based universal advance digital directive for free. The directive can be digitally signed, is encrypted and stored so it is available to you any time you might need it.

The American Bar Association has an online form to establish a universal durable power of attorney for health care that can be used in 45 states. The ABA has also compiled a list of resources by state.

The Caring Conversations Workbook can help you establish a durable power of attorney as well as an advanced directive.

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