Now is the time for advance health care planning

The letter

Several months ago, I received a thick envelope in the mail from my parents.

I wasn’t expecting anything from them, so I was surprised to read a letter addressed to me and my three sisters, along with copies of my parents’ advance directives. Yet the most powerful feeling I had was one of gratitude.

Through the contents of that envelope, our parents made it clear they wanted us to understand what kind of care and medical treatment they would want if they became too ill to make their wishes known.

They did this to make it easier on my sisters and me in case we are ever faced with making medical decisions on their behalf. They also wanted to reduce the risk of conflict between their children in what can be a very emotionally charged situation.

What a caring and important gift.

The conversation

Since then, my parents, sisters and I all sat down together to talk about their wishes in person. This valuable conversation gave everyone a chance to ask specific questions and talk about beliefs and feelings.

I can’t say the whole conversation was easy. It is difficult to talk about possibilities of people you love facing severe illness, injury or death. This difficulty makes it tempting to avoid the conversation.

But avoiding the conversation may have negative implications down the road. Family members could one day have to guess what a loved one would want.

We all know death is an inevitable part of our humanity. Many people have thoughts of what they do and do not want to experience in their final months, weeks and days. We should not assume that loved ones already know what we would want.

In my family, for example, we found we had different opinions about what kinds of medical treatments we would want for ourselves if faced with a potentially irreversible illness or injury. By talking through this, we are now better equipped to honor the wishes of our parents and one another.

A nurse’s view

I’ve shared my experience as a daughter and sister. But I’m also a nurse, and I’ve cared for patients and families who have had advance directives and related discussions and those who have not.

When patients cannot communicate for themselves, the health care team often asks family members to make decisions about what the patient would want.

For instance, family members may be asked if a patient would want a tube placed in his stomach either through the nose or by surgery (commonly referred to as a feeding tube) or to be placed on a breathing machine. If the person’s medical wishes have been communicated in writing ahead of time no one has to guess what the patient would want. This helps family members have a shared understanding about a patient’s wishes. It can have the added benefit of reducing the chance of disagreements within the family.


In Texas, the Directive to Physicians and Family or Surrogates, or living will, is used to document these wishes.

The website mydirectives.com is a digital advance care planning and advanced directive storage service that provides flexible directives and easy retrieval.

Other types of documents are also available for advance care planning, including many that are free.

Specific laws for advance care planning vary by state, so make sure you have the right information for the state in which you live. If you’re not sure where to find the information, ask your health care provider.

You may also wish to view resources related to advance care planning from the Centers for Disease Control and Prevention.

Is advance care planning on your gift list?

Over the next few weeks, many people will be giving and receiving gifts. Consider exchanging the gift of an advance directive with your loved ones. There’s no better time to discuss this important issue.

About the author

Sonya Flanders, RN, ACNS-BC
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Sonya is an adult clinical nurse specialist with Baylor and moved to Texas from Canada to become a Baylor nurse. She's focused on enhancing health education of older adults along with their families and caregivers.

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Now is the time for advance health care planning