Not excited about advance care planning? Here are 8 unorthodox reasons you should be!

Friday, 01 Jan 2016 08:19

About Dr. Monica Williams-Murphy (120 Posts)

Dr. Monica Williams-Murphy is a Board Certified Emergency Medicine Physician, who practices in one of the largest emergency departments in the United States at Huntsville Hospital. Through her writing and speaking, she is devoted to transforming the end of life into a time of peace, closure and healing. Media Page


By now you’ve surely heard that Medicare is going to pay doctors and other qualified healthcare providers for advance care planning with patients in 2016.

Aren’t you excited?!?

Ok, so if you are not utterly thrilled or even if you are nonplussed about the whole issue, then let me give you a different perspective on why you should rush into your friendly local doctor’s office to make a living will and chat about your future.

Here are 8 unorthodox reasons to create your own advanced care plan in 2016:

 1. You don’t want your Aunt Bertha changing your diapers.

Maybe your Aunt Bertha did change your diapers when you were 6 months old, but do you really want her cleaning your feeding tube and wiping up your poop stains when you are 60? I mean heaven forbid that you end up in a chronically dependent or even vegetative state at such a youthful age, but what if…??? Did you even want to be kept alive in such a state at all…??? Certainly something to think about. Maybe you should give Aunt Bertha a call?

2. The loudest person in your family may not have your best interest in mind.

Oftentimes the loudest relative “runs the show” in the hospital- by guilt, intimidation, and a host of other aggressive or passive-aggressive strategies. If you don’t want “you-know-who” making decisions for you or bullying around your other relatives, while you lie helplessly in the hospital bed, then for Pete’s sake, choose and document your own healthcare proxy today! Make sure they know EXACTLY what’s acceptable and not for you.

3. I’ll bet you know who you DON’T want making decisions for you.

Simply put, some people can handle this kind of pressure and some people can’t. The people who would wilt under life and death decisions on your behalf should NOT become decision makers for you, either by intention or default.

4. Hell hath no fury like your family fighting over your fate or your fortune!

I’ve seen feuds break out around a deathbed that would make the Hatfields and the McCoys cringe. I always want to scream, “What the hell are you people doing? Can’t you see that your loved one is dying here?” (Of course that kind of outburst is never good for the physician professionalism scorecard, so I usually manage to translate the sentiment into something a bit more PC.) So, please, please I beg you to have your fate and your fortunes pre-determined before that fateful and inevitable moment arrives!

5. Grudges can come back to bite you.  

One time the closest available relative to my unresponsive patient on full life support was his estranged wife. She had carried a grudge for 20 years. When we finally tracked her down to make a decision for my patient, with glee she whispered evilly, “Pull the plug.” (YIKES!) I’m pretty sure that guy would have had someone else in mind to make this decision, but IT WAS TOO LATE! No advance care plan was in place with his doctor. (I sense that you are getting my drift…)

6. No one knows your secret priorities.  

During one of my traveling lecture series last year I met a gerontologist who shared some of the idiosyncrasies of his advance care plan with me. He had in writing, that should he become demented and placed in a nursing home: 1) Under no circumstances should he ever be physically or chemically restrained, and 2) He should be allowed to have sex with anyone who is willing to engage him :)

7. No one knows you like you… and you deserve a fitting exit. 

I would like to die on a blanket under the oak tree at bottom of my field. My dad would like to be buried in a bright red racecar motif casket. My husband wants a Viking funeral pyre. I’m sure you have some pretty unique idea about your final goodbye as well… do you have the plan in place?

8. Embracing death will allow you to embrace life. 

Is this too much for you? Think it’s too morbid? Let me tell you the great secret… when you embrace death in its inevitability, then each moment of life itself becomes more precious. Now will never come again. Planning for the end-of-life awakens you to the gift of this very moment of life, this very second. What a gift.

“The doctor will see you now…”

Our Book: It's OK to Die

"It's OK to Die" is a ground-breaking book filled with graphic stories straight out of the Emergency Room illustrating how most Americans are completely unprepared for death and dying. In response, the authors have created a unique and comprehensive guide urging EVERYONE to prepare in advance, to assure their own peace and to prevent the suffering of their loved ones.
Learn More..

5 thoughts on “Not excited about advance care planning? Here are 8 unorthodox reasons you should be!

  1. Roxanne Crisman

    Boy is this going to be an excellent book to purchase. I see so much of this in my field of work. You get 2/3 of the family who see the end is very close, and then just one family member who is still in denial, and won’t let go for love nor money, and they want everything done, despite what the patient’s wishes are and the rest of the family. Then the patient remains a full code, and everything has to be done, despite the fact, that the patient didn’t want it this way. This is one time I could just look at them, and say, You know something, It’s not about you. Roxanne

  2. Rea

    Very clear, moving, sensible presentation. It continues the push toward end-of-life planning for all — so that the end can really be a time of healing, closure, and peace — and life itself can be more appreciated. Lovely, thoughtful essay! A New Year’s gift for all of us. The birth of a new year. Something to think about…and we do…and we will.

  3. Dave Savage

    In addition to the great advice in Monica’s book, also sharing about what kind of satisfying and appropriate end of life celebration – service or ceremony you’d create for your loved ones or you’d want for yourself is important.

    “Dad, there was another news report of a traffic accident on the news today and it got me thinking about what I’d do with and for you if that was you in the car. If you don’t tell me differently, this is what you’re likly to get…”

    “What would your advice to the family be if I was the one in that car accident?”

    Some good ideas are in our website

  4. Dr. Monica Williams-Murphy Post author

    Chaplain Marci Pounders sent me two additional reasons so that you might have a 10 commandments/10 unorthodox reasons for ACP.

    9. Thou Shalt Make Allowances for Anticipatory Grief.

    10. Thou Shalt Have a Pre-Arranged Funeral Plan so the County Coroner Won’t Have to Unceremoniously Scatter Your Ashes in a Landfill.


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