This piece is presented by Sanford Health.

By Gretchen Spars, Sanford Health ethicist

The holidays are the perfect time to sit down and “talk turkey.” This doesn’t mean discussing football, shopping or preparations for the big meal. Rather, with family members already congregated, it’s an ideal time to have candid, thoughtful conversations about everyone’s personal health care preferences. It will benefit everyone to consider and share their medical wishes and preferences while they can, regardless of their age.

Talking to loved ones about advance health care planning can be uncomfortable, but critical decision-making moments are often made all the more difficult when loved ones are forced to guess about critical care preferences or end-of-life goals. When a sudden medical event or accident occurs that prevents someone from participating in his or her own medical care, family members will want to be informed decision-makers.

When talking with loved ones about advance care planning, start by asking open-ended questions. Examples include:

• What concerns you most if you were unable to make your own medical decisions?
• What are your hopes and fears regarding your health care?
• Who would you trust to make decisions or speak for you if you were unable to do so? Have you talked to them about what you would want?
• What are the best and worst care scenarios that could happen?
• What options do you believe you have?
• What can you share with me about your end-of-life wishes that is most important to you and would bring you comfort?
• What does a good day look like to you?
• What can I do to support you?
• If you were diagnosed with a life-limiting illness or involved in a major accident, what kinds of medical treatment would you want?

Most people have some idea of which medical interventions they feel are suitable for their personal care, but these wishes are often never communicated. An advance directive tells the family and physician what a patient would want if he or she were badly hurt or have a serious illness that keeps the person from saying so. This legal document appoints a health care agent and states desires about quality of life, medical treatment, attempts to restart the heart and breathing, artificial feeding or being put on a ventilator. A health care agent should have a calm disposition, understand the person’s medical preferences and be able to advocate. As long as a patient can still make his or her own decisions, the advance directive won’t be used. The patient can stop or say no to treatment at any time.

In the face of illness, a person also can consider shared decision-making, which allows for collaboration with a health care provider regarding treatments, interventions and end-of-life decisions but still upholds a patient’s right to make his or her own decisions.

It’s natural to want to put off thoughts of crisis and death, but it’s important to share and discuss about certain health care desires while everyone is able to. This November, encourage family and friends to share about their personal medical preferences. Open discussions will allow everyone to be aware and respectful of each other’s wishes.

To learn more visit sanfordhealth.org, keyword: advance directive.