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    Are Americans Afraid to Talk About Dying?

    Talking to Family, Friends Helps Make End-of-Life Decisions


    A living will does not mean that doctors won't try everything medically possible to save your life. It means that you get the opportunity to explain under which circumstances you do not wish to have your life prolonged. In many people's minds, this is a point at which they can no longer take care of themselves or make decisions for themselves. For many, it's about quality of life.

    In these situations, it's hard for doctors to try to interpret complex legal documents. That's why many doctors would prefer that patients designate a health care proxy. A health care proxy -- in some states called a durable power of attorney for health care -- is the person you choose to speak for you when you're not able to speak for yourself. Different states have different laws, but all provide a way for you to do this.

    "Naming a health care proxy gives me, as a doctor, a person I can actually talk to," Goldstein says. "It's someone who can say, given the situation, what would this patient want. A health care proxy can sometimes be more helpful than a living will because it gives us a living, breathing person who can answer whatever questions may come up."

    How can we ask someone we love to do this? Start slow, Lynn advises. And keep talking.

    "There are usually some pretty natural openings," she says. "Shows on TV, or a country music song, or opera. It is a matter of looking around for the things that make it natural to have short conversations, over and over again.

    Unfortunately, Lynn says, what we want for ourselves and for our loved ones may simply not be available.

    "You can't write a living will for care that isn't available," she says. "If a person wants to die at home with good care, but there isn't good home caregiving in their community, you can choose all you want and so what. ... It is easier to get an implanted defibrillator than to get meals on wheels."

    Lynn urges people to think about the kinds of care that are actually available to them -- and to demand more.

    "Make yourself a political force," she says. "Ally with other family caregivers -- because we all are or will be or have been caregivers. We have to build a health care system that is trustworthy, reliable, and sustainable. So get to know these issues. We have to build a system that is good enough to take care of us."

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