Close to Home: Why it’s important to have that talk about death and dying

My husband says it's like flossing your teeth: You know it's a good idea, but it just doesn't seem very urgent. Unfortunately, life shows us otherwise.

In the past two years, both he and I have had friends die well before their time, as a result of accidents and health conditions.

It always seems too early to have that conversation, until it's too late. Some of us (23 percent of Californians) have completed an advance health care directive, and that's an essential step. It puts critical information in black and white. But in health care decision-making, there's often a lot of gray.

For example, I don't want a ventilator as a permanent part of my life, but I might want one temporarily, depending on circumstances.

That's the kind of nuance that a check box can't convey. And that's why conversation is so essential. What would you want if you couldn't speak for yourself? What's important to you at your present stage of life? What tradeoffs would you consider to stay alive? How might your considerations change with a new diagnosis? With age?

These are hard conversations to have, especially if you aren't sure exactly what your options are and what you should discuss and with whom.

My Care, My Plan: Speak Up Sonoma County is a source for information, guidance and tools to support you in speaking up now, before it's too late. My Care, My Plan is a community initiative, a collaborative of organizations and individuals from the private, public, nonprofit and volunteer sectors who want to raise awareness about advance care planning.

This year, we have started holding free, quarterly workshops to provide information and answer questions about advance care planning. Our goal is to help all Sonoma County residents over age 18 feel confident to speak up about the kind of care you would want - before a crisis occurs. We hope to inspire you to talk with your friends and family about your wishes and preferences, to find the right person to be your agent or advocate to speak for you and to complete an advance health care directive. And then we hope you'll ask your friends, “What are your wishes, should you have a health care crisis?”

As a therapist, I know well that some of us don't have a child, sibling or partner to entrust as our durable power of attorney for health care. My Care, My Plan can inform you of other choices. You might consider a close friend, your attorney or a professional fiduciary for this role. But you also don't have to have an agent. Instead, you might elect to write out your preferences in some detail and attach that information to your advance health care directive.

Even if you don't have a personal agent for healthcare - and perhaps most crucially if you don't - it is still important to talk with your friends, family and doctors about what you want and give them copies of your completed directive. That way, at a time of crisis, someone can present your directive to the medical team so that treatment decisions can be guided by your written preferences.

No matter what your situation, talking about and documenting your wishes for end-of-life care is the ultimate gift to those who care about you, relieving them of the burden of uncertainty so that they know the treatment you receive is the treatment you would want.

Registration is open now for our next community event on July 11 in Santa Rosa with Dr. Gary Johanson, medical director at Memorial Hospice & Home Health.

For more information and to register, go to MyCareMyPlanSonoma.org.

Dorothy Foster is a psychotherapist in private practice in Santa Rosa and co-chair of My Care, My Plan: Speak Up Sonoma County.