Organize the Essentials—Like Advance Directives

If that title sounds a little familiar, it’s because that’s the name Mom gave our company many years ago.

It was 2008 and I’d had an itch to start my own business for some time, but didn’t know exactly what I wanted to do.

I’d created a much-less-official writing-focused endeavor in 2006, which I named The Corner Wordsmith.

However, I had no idea what I was doing in terms of finding clients or making any type of income with it.

Since that didn’t work out, I wanted my next business endeavor to be more concrete, focused, and formal.

When I learned that professional organizing was actually a thing, I jumped in with both feet since organizing stuff is something I love to do.

With visions of the shoeboxes full of medicine bottles in total disarray that I’d encountered over the years in patients’ homes; and the blank look I’d often received when asking someone to tell me their health histories or wishes for their care—I decided to focus my work on health information organizing and estate information organizing.

Which is how Mom came up with the name, Organize the Essentials LLC.

I’ve written about that journey before, so I won’t repeat those details here.

Instead, I want to talk about one aspect of the essentials we all should organize, which is communicating our wishes about what we do and don’t want done when it comes to our healthcare—aka, advance care planning.

Being ready for the unexpected.

You may think my work as a hospice nurse is what fuels my passion to talk about being prepared for end of life.

While that’s partly true, what’s more the case is that the experience helped me be comfortable talking about the topic.

However, what really creates a sense of urgency for me in this context is that too many people think nothing unexpected will happen for which they should prepare—and that’s based on my experience witnessing so much unexpected tragedy while working in critical care.

That’s one of the reasons I’m passionate about this topic, and why my upcoming novel is about the last 60 seconds before death.

Because none of us knows when our final moment will be in this world—which is why we need to be prepared on a variety of fronts.

After all, any of us could face what Jeanne Smith endured in 1978, when her young husband and father of two died unexpectedly in a car accident the night before a routine surgery for a hernia repair.

In preparation for his surgery, he’d organized all the essentials Jeanne would need in case something happened to him during the procedure.

So when this unexpected tragedy occurred, the loving gift her husband had prepared helped her through the mountain of responsibility she was suddenly required to deal with alone while in the midst of her grief.

You can read more about Jeanne’s story on her website—as well as the resources she offers—but long-story-short, this experience eventually led to the creation of her business, Exit Stage Right, and she became a pioneer in the field of estate organizing.

I met Jeanne in the fall of 2008 when I attended one of her trainings—and came away with an even greater resolve to help others be prepared.

Helping you prepare.

Someone asked me recently what I’m most passionate about.

My response?

Helping people know Jesus before they die.

In that context, I would love to connect with those who are facing end of life and don’t yet know Jesus. (I plan to write more about that mission field next week, but I’m mentioning it now in case you know someone in that situation. If so, please send them my way so we can talk frankly about dying, Jesus, and preparing for what comes next).

But another thing I’m passionate about is helping individuals remain in control of their healthcare—which is what advance care planning is all about.

Although considering and discussing the potential for unexpected health events for ourselves and our loved ones may be uncomfortable, these are such critical conversations to have.

Otherwise, we run the risk of placing our fate in the hands of a healthcare system that typically defaults to doing what’s needed to extend someone’s life, regardless of what that might mean.

Don’t be maudlin, Sue.

That’s what Mom told me one day when I was apparently gazing at her with sadness in my expression.

Her health was in a steep decline and I remember what I was thinking at that moment: How much I was going to miss her when she was gone.

Through tears, I told her that.

Honestly, I don’t remember her exact response, but we likely teased each other about her use of such a word.

We were both word-nerds, so we often had fun with out-of-the-ordinary vocabulary like that.

Another high-brow favorite of hers was accoutrements—a term she playfully used to refer to the fancy scarf I’d given her for Mother’s Day several weeks before she died.

As I was repositioning her one day and rolling her onto her side, I heard the twinkle in her tone as she said, “Where are my accoutrements?”

Yes, even as my mom was in her final weeks and days, we were still having fun. ?

And some of that was possible because we’d already dealt with the hard stuff long before.

Mom had completed her advance directives many years prior, so I knew exactly what she did and didn’t want done.

And though we’re relatively young—which feels questionable some days—Dave and I completed our advance directives many years ago, too.

The nuances of advance care planning.

Advance care planning is a process of discussing, determining, and documenting what an individual wants in the context of healthcare treatments in various situations.

This concept is so important that in 2016, the U.S. Centers for Medicare and Medicaid (CMS) started reimbursing healthcare providers for having advance care planning discussions with their patients.

One component of advance care planning involves the creation of advance directives.

Advance directives are legal documents a person creates that outline their wishes for care if they’re unable to speak for themselves.

They include a living will and the designation of a healthcare surrogate—which may also be referred to as a healthcare proxy or a medical durable power of attorney, among other terms.

This designated individual can be anyone an individual trusts to abide by their wishes if they’re unable to speak for themselves.

Anyone can complete their own living will and organizations like the National Hospice and Palliative Care Organization (NHPCO) offer state-specific forms you can download for free.

Although those who have a living will sometimes assume they also have a Do Not Resuscitate Order (DNR), the two are very different documents.

Unlike a living will that a person can create on their own, a DNR is a medical order that must be completed in collaboration with the patient’s doctor, who must sign it.

Another type of medical order in this context is POLST or MOLST—aka Physicians Order for Life-Sustaining Treatment or Medical Order for Life-Sustaining Treatment—which offer more options than a DNR.

POLST may be referred to by other names, depending upon the program involved, and is only recognized in certain states. Currently, MOLST is only used in New York.

I won’t try to go into all of that here, but you can find a nice explanation of POLST on the Daily Caring website and further clarification on the National POLST website.

Help yourself and your loved ones.

If you don’t yet have advance directives in place, I encourage you to consider doing so and having these important discussions with your loved ones.

And if you’re worried about a loved one who doesn’t have them, but don’t know how to bring it up, a great place to start is with The Conversation Project—which offers some wonderful resources to help you get that conversation going.

There’s also additional information on my website on the Resources for the Journey page.


This post is adapted from Sue’s Perspectives column in the latest edition of The Empowered Traveler™ Newsletter. If you’re not already a subscriber, you can do that here: Subscribe to Sue’s newsletter.

Sue Montgomery is a Christian writer/content creator who's also been a hospice nurse, family caregiver, health coach, and professional organizer. Now she's helping Baby Boomers like herself embrace the Boomer Continuum™ of agile caregiving, graceful aging, and peaceful dying—with Christian faith and simplicity to focus on what matters most.
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