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Discussing advance directives with loved ones

Posted at 9:22 AM, Apr 06, 2023

How do you make the best decisions for your health before something goes wrong? It can mean some tough conversations with loved ones.

“If there's one thing that we all have in common, it's our mortality,” said Dr. Solani Shah from Intermountain Health.

Shah works with patients facing the biggest questions in live, usually with loved ones by their sides. And she’s learned a lot about the importance of clarity.

“When you sit down with your loved ones and talk about your values, what brings you meaning and joy in life, that makes it a lot easier for your family and friends to then make decisions for you in the future should an unfortunate situation arise,” said Shah.

The hope…making an advance directive opens the door for a meaningful discussion for everyone involved.

“When you can discuss things not necessarily in the terms of, oh, would I want this life support or the help of this machine? You know, often discussing things in that medical way can feel very cold. But when we talk about what gives us meaning, and joy, and what allows us to thrive and really experience life, when we're able to list those things and let our loved ones know. Then they can apply that knowledge to medical interventions and think about will this allow my father to keep playing golf or to fish or to travel, as they've always wanted to do,” said Shah.

Because it is about possible future events, an advance directive should be changed in the face of life changes. Changes Dr. Shah speaks about in the ‘Four D’s.’

Diagnosis – if you learn you face a particular illness, think about how that may change your perspective.

Decline – a health decline may have the same effect. A reconsideration of your wishes.

Divorce – often a spouse is the designated agent for decisions. If you go through a divorce, you may want to reconsider changing your advance directive.

Death – If your chosen agent dies, who would you then designate?

Another thought from Dr. Shah – sometimes it helps to designate more than one person, so long as you are confident they can work well together.

“When that patient is able to tell me, this is the person or these are the two or three people that I want making medical decisions for me, and they are the ones who know me the best and have my interests at heart, then that's what I document and that's what I trust and listen to,” said Shah.

It's important to keep all your information up to date and check the legal requirements for paperwork in the state where you live. Advance directive forms can be completed online, on paper, at home or in the doctor’s office or hospital.

“It’s always too early, until it’s too late,” said Dr. Shah.

For more information visit Intermountain Healthcare.org or National Healthcare Decisions Day for state-specific requirements. Advance directive forms for Utah in English and Spanish can be found on the Intermountain advance directives webpage, the Intermountain patient portal, My Health+ or here.