Step 4: Considering Some Questions and Topics


Now that you have a general idea of some of the topics that are important in Life Care Planning and you have identified some of the people with whom you should have these conversations, there are some questions you should consider. You do not have to discuss all these topics with everyone, and you may choose to discuss only some of these topics, or none of them. We are all different and we approach questions about disability and end of life medical care differently. There is no right or wrong way, so do what is best for you. 
The information below may be helpful to you but is not a substitute for legal advice.
(Content is courtesy of the
Office of the Attorney General of Arizona, Mark Brnovich.) 
 

1  QUALITY OF LIFE AND PROLONGING LIFE 

Consider your values, beliefs, and preferences as to the length of your life in relation to the quality of your life, and whether you would or would not choose to prolong your life regardless of the quality.

  • What "quality of life" means to you: Which of the following or other factors are important to you in considering the quality of your life: The ability to think for yourself? Consciousness? The ability to communicate? The ability to take care of your personal needs? Your privacy and dignity? Mobility, independence, and/or self-sufficiency? The ability to recognize family and friends?
  • Your responsibilities: Are there certain people or duties that you feel you have an obligation to live for?
  • Who/what? Do your choices change if your obligations to those persons or duties are resolved? How? When?
  • Your age: Does your age play a factor in any or all of your choices? Do your preferences change depending on how old you might be if these decisions must be made?
  • Your religious or other beliefs: What is the importance of your religious beliefs or other values in making these determinations? Who can you talk to about this?
  • Where you might be medically treated or “placed”: Is your future living environment an important consideration for you? How do you feel about living in a nursing facility or other medical care facility for ongoing medical treatment?
  • Finances: Is financial cost a consideration for you when you think about disability or end of life matters? What aspects of finances are you considering?

2  LIFE SUPPORT

Consider the following common life support measures: (1) food and/or fluids (nutrition/hydration); (2) cardiopulmonary resuscitation (CPR) by equipment, devices, or drugs; and (3) breathing devices such as a ventilator.

  • Under what circumstances do you want some, all, or no life support to be administered? To be withheld? To be removed or stopped? Why and which ones?
  • What about withholding or withdrawing life-sustaining treatment if you are known to be pregnant and there is the possibility that with treatment the embryo/fetus will develop to the point of a live birth?
  • What about medical care necessary to treat your condition until your doctors reasonably conclude that your condition is terminal or is irreversible and incurable or you are in a persistent vegetative state?

3  ORGAN DONATION

You can determine if you want to donate organs or tissues, and if you do, then what organs or tissues do you want to donate, for what purposes, and to what organizations. Or, you can leave the choice to your representative.

  • Who decides: Do you want to decide about organ/tissue donation, or do you want your representative to do so? What tissues/organs: Do you have preferences about what tissues or organs to donate -- Heart? Liver? Lungs? Kidneys? Pancreas? Some or all of the above?
  • What purposes: Do you have preferences as to what uses might be made under Arizona law of your tissues or organs -- Transplantation? Therapy? Medical or dental education? Research or advancement of medical or dental science? Some or all of these uses?
  • What organization: Do you have preferences as to what organization should receive your tissues/organs?

4  AUTOPSY 

Under Arizona law an autopsy may be required when a person dies who was not under the current care of a physician for a potentially fatal illness, or the physician is unavailable or unwilling to sign a death certificate. This might happen if a person dies at home. However, if the person’s doctor is willing to sign a death certificate or if the person is under the care of a hospice and its physician will sign the death certificate, an autopsy will probably not be required.

If there is no legal reason to require an autopsy, you can decide whether upon your death you want an autopsy or not, or whether you want your representative to choose for you. There is usually a charge for voluntary autopsy. After the autopsy is completed the body is transported to the mortuary for burial or cremation. This can be a sensitive topic at the time of death, and you can help your family and loved ones by making your preferences clear. 

  • Who decides: Do you want to decide about an autopsy if it is optional at the time of your death, or do you want your representative to decide?
  • Autopsy: If an autopsy is not required by law when you die, do you want or not want an autopsy performed?
  COMFORT CARE AND OTHER SUPPORT WHEN YOU ARE DYING
  • What are your preferences and directions about pain and pain medication?
  • Do you want a comfort care medication or procedure even if it might make you drowsy, sedated, or have other effects?
  • Do you want certain people to be with you when you are dying if they can do so? Who?
  • Do you have a preference about where you want to die? At home? In a hospital? Somewhere else?
  • Do you want your church, synagogue, mosque, or place of worship advised if you are dying?
  • Do you want certain music, poetry, or religious readings? Do you want silence? Radio? Television? 

REMEMBRANCES TO LOVED ONES, AND FUNERAL OR OTHER ARRANGEMENTS
  • Do you have anything you want to be remembered for, or any special words to share with anyone that you would like to write down?
  • Do you want to be buried or cremated?
  • Do you have preferences about a memorial service? What? Where?
  • Are there certain people you would like in attendance? Are there songs, readings, or rituals you want performed?