Why Don't We Plan for Death and Dying Like We Shop for a Car?

Happy couple chooses to buy a car in showrooms

When we are ready to replace a car, we consider several makes and models, scores of optional features, price and performance; we talk with friends and ask their opinions; and we take test drives. According to the Chicago Automobile Trade Association, used-car buyers spend an average of 15.25 hours shopping for a car online, which doesn't include talking with others or taking test drives.

Yet, researching end-of-life care options, making decisions about our final wishes, documenting them and discussing those decisions with loved ones isn't something most people spend time doing. Ever.

Talking about death and dying can be tough, even though it is imperative if you want your wishes followed. To continue with the metaphor, I'm not suggesting people "take a test drive" when it comes to death and dying. But we do know that someday, we ARE going to buy a car (die) so it makes sense to learn a little more. We can choose the "make, model and features" so our loved ones won't have to guess, be confused, or have regrets that they didn't do what we would have wanted.

Wouldn't it be worth least 15 hours of your time to research and document your plans and give your loved ones the gift of knowing what you have decided?

For example: More than 80 percent of Americans say their loved ones "know exactly" or have a "good idea" what their wishes would be if they were in a persistent coma, but only 50 percent say they've talked about their preferences. Many people think hospice is a place you go a few days before you die when, in reality, both palliative care and hospice care are available to people for months prior to death and can provide comfort and pain management, a break for caregivers, and valuable information that few people seek out on their own.

Here are some of the ways you could spend your 15 hours:

  1. Choose someone to make medical decisions for you if, for some reason, you can't. They are called a health care agent, proxy or durable medical power of attorney.
  2. Consider various treatment options you may or may not wish to take part in if you are at the end of life. Examples include resuscitation, feeding tubes, being intubated with a ventilator, antibiotics, and continuing to eat and drink.
  3. Plan your final dying days and hours. Do you want family or friends called in?  Music (if so, what kind)? Poems or spiritual readings? A cocktail party?
  4. Decide what you want done after your death (for example, organ donation, burial, green burial, cremation, a memorial service, a party).
  5. Write your own obituary or create an ethical will for your loved ones.
  6. Choose what will happen with your e-mail and Facebook accounts when you die.
  7. Tell your loved ones what you've decided.
  8. Complete checklists and forms that help you get it all done and also document your wishes legally.

Here's my own example: If I have a terminal illness, I would like to have a living wake—a pre-funeral. We'll have the party before I die! I plan to have a dinner with music, dancing and comedy.

In the past, I told family and friends that I wanted to hire Robin Williams to move through my party and entertain. Unfortunately, I won't be able to have him there now. One of my favorite quotes attributed to him is: "Death is nature's way of saying, 'Your table is ready.'"

Here are some online resources to help you start your own conversations about death and dying:

When you buy a used car, they tell you to "get a Carfax," shop for deals and learn to negotiate. You can do the same when you make your end-of-life plan. The paperwork is straightforward. The shopping is fascinating (for instance, did you know, if you are cremated in Washington state, you only need to buy a $75 container, not an expensive coffin?). And the "negotiating" is having those conversations with your friends and family to make sure they understand your wishes and will follow them, rather than in a dealership under a high-pressured sell.

Also, you can change your mind any time you want and make new plans, as long as you document them. Once you buy a car, you usually can't take it back!

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Contributor Dori Gillam manages Aging Your Way at Senior Services. She is also a Certified Hospice Volunteer and facilitates Positive Endings—discussions on end-of-life planning that include helping participants have delicate and pragmatic conversations with loved ones. Learn more about Dori's work at www.dorigillam.com.

Online Resources

Aging with Dignity (The Five Wishes)

Compassion and Choices of Washington (advanced directive form)

Consumer's Toolkit for Health Care Advance Planning (American Bar Association resources)

The Four Essentials of End-of-Life Planning: Are You Good to Go? (AgeWise King County, January 2014)

It's OK to Die (end-of-life planning checklist)

My Directives (online completion and storage of forms)