Conversations and Advance Care Planning

Susan P Plummer, MSW, Ph.D., Director, Alliance for Living and Dying Well

Conversations and Advance Care Planning

Moving through our lives with a living awareness and acceptance of our mortality can bring us into greater freedom, compassion, meaning and sense of belonging. It is largely our fear and denial of death that inhibits a life-giving embrace of our mortality.

Some people believe that being more conscious of the eventuality of death is a morbid, life-denying proposition. But actually, the opposite is most often the case. When we are more aware in our daily life that we will not live forever, we tend to live more fully. We feel more vividly the preciousness of life, what really matters and experience a deeper sense of connection with life around us. Many of us have had this experience, when we learn of a loved one’s terminal illness. Our love for this person and the gifts he or she bring into our life, suddenly come more into focus.

Actively knowing that we will someday die brings forth the truth that we are all in this together. In other words, no one is exempt and we all need each other in navigating this universal, yet mysterious, phase of life.

We may belong to a particular religious faith or follow traditions that offer significant fellowship and comfort, but there is often something innately “alone” when it comes to our death, because only we ourselves can die our own death. So many of us are further isolated because we experience fear and anxiety about death within a kind of lonely bubble.

Other than funerals and memorial celebrations, it is rare to find opportunities to share openly with others our thoughts and feelings about this fundamental part of life. If these kinds of conversations were more often a part of and available in our everyday lives, we may feel our isolation and fears lessen, and discover a renewed sense of connection and fuller living.

Greater opportunities for this kind of sharing with each other would have another very important impact. We would be more likely to experience the kind of death we desire. Death, like all major life phases, is important and our experiences around our death matters, not only for ourselves but also for our loved ones.

Advance Health Care Directives

Having an up-to-date Advanced Care Directive is one of the best ways to insure that your wishes will be honored. Where do I wish to die? Who do I want to be with? Under what circumstances do I wish to have life support, to be resuscitated? Who do I want to express my wishes if I am not able? These are the questions that you talk about in your Five Wishes conversation with loved ones so now everyone involved understands what is important to you.

Having a current Advanced Care Directive is not only for those near the end of their lives. It is recommended that anyone over 18 years of age have one. They should also be periodically up dated, as situations, beliefs and wishes change over time.

Completing your Advanced Care Directive is also a gift to your loved ones. It will be some comfort for them to know clearly what your wishes are if you cannot tell them at a critical time. Everyday, in hospitals all over the country, families are struggling over whether to begin or to continue life support treatment for a loved one. If it were clear to all involved, and documented, as to what the person desired, families could feel more comfortable with difficult decisions and perhaps be freed to attend to their loved one and each other in more fulfilling ways.


A new Advance Health Care Directive for Santa Barbara has been developed locally and is now being used by the Alliance, hospices, Sansum Clinic and Cottage Hospital. Click here to learn more about MyCare.