Sept. 4, 2007

COLLEGE STATION – If nothing is sure in life except death and taxes, this is also true: Both need to be planned for. That's the advice from Dr. Joyce Cavanagh, Texas Cooperative Extension family economics specialist.

And the hardest part about planning for end-of-life issues may be talking to loved ones about it, she said.

"It's not easy or comfortable to talk about illness, death or losing somebody you love," Cavanagh said, but it needs to be done because "your family needs your help to make appropriate decisions on your behalf. Nobody knows better than you how you want to be cared for if you are not able to recover from a serious illness or injury."

But before you can talk to your loved ones about your end-of-life wishes, you need to think about them yourself, she said. Start with these questions, offered by Oregon State University's Extension Service:

- What are the basic functions you must have in order to feel you want to continue living? For example, do your very basic needs include the ability to recognize or respond to loved ones?

- Do you have spiritual or religious beliefs that affect how you feel about terminal illness, treatment decisions or death and dying?

- If you are diagnosed with a terminal condition, would you want to have certain life-sustaining treatments? Likewise, what life-sustaining treatments would you refuse?

- Do you have a certain physician you trust to help your family make decisions about your care?

- Have you designated a healthcare agent to make decisions on your behalf, and do your family and doctor know who that agent is?

- Do you know of anyone you would not want involved in your health care decisions?

- If you have the choice, would you prefer to die at home, in a hospital or in a nursing home?

"Once you have thought through these questions, it's time to talk to others," Cavanagh said. "Talk to your family about your wishes, and tell them who you have chosen to be your healthcare agent. Explain that this is the person you want to be responsible for helping the medical team understand your wishes regarding terminal illness and other healthcare issues."

Try to discuss these issues when the whole family is together, she advised. If that isn't possible, talk to all of them individually or in smaller groups. You could even make a video or audio tape in which you spell out your end-of-life healthcare wishes, or write personal letters to everyone in the family.

"If you express your feelings to all of your family, conflict will be less likely to arise later," Cavanagh said.

Consider making medical directives that specify what kind of end-of-life care you would or would not want, she said. For information on medical directives in Texas, go to http://fcs.tamu.edu/money/your_money/ and click on the link to "You Have the Right to Decide." And make sure family members know where these directives can be found, if they don't have copies of them.

"Tangible expressions of your wishes are comforting to families during times of crisis," Cavanagh said. "It helps everyone know that the decisions that are being made are the ones you would want.

"No matter what your age or situation – whether you are married, single, widowed or divorced – planning is an important way to make your life more secure, to ensure that you have maximum control over your life and future, and to give you and those you love peace of mind."

For more information, Cavanagh suggested the American Bar Association's "Advance Planning Took Kit" at http://www.abanet.org/aging/toolkit/ .

For more information on this and other economics issues, visit Extension's Family and Consumer Sciences Web site at http://fcs.tamu.edu/ and click on the link to "Money."