Transitioning in to Retirement Spiritual Health and End of Life Planning by Roy O. Elam, III, M.D. Associate Professor of Medicine Medical Director, Vanderbilt Center for Integrative Health

Spiritual Health in the Last Half of Life “Beginning to Let Go of the Ego”  Acknowledge Regrets seek forgiveness begin to let regrets go  Celebrate Accomplishments and Successes begin to let them go  Seek Council if Letting Go Is Not Leading to Peace  Know Your True Self the source of wisdom, service meaning and love  Contemplative Practice Can Lead to Happiness and Wellbeing.

Advance Care Planning FAQs What is an advance directive? And advance directive is a document outlining your wishes for healthcare, so they will be known in the event you are not able to communicate those choices. There are two parts to an advance directive: 1. A durable power of attorney 2. A living will

What is a durable power of attorney for healthcare?  A durable power of attorney for healthcare is a document in which you name someone you trust to communicate your healthcare decisions for you if you become unable to make or communicate those decisions yourself. What is a living will?  A living will documents your written wishes about life- sustaining treatments that are directly related to quality of life that is unacceptable to you in the event you are unable to communicate those wishes.

Who Should Have Copies? Health care providers and hospitals Health care agent Family

Advance Care Planning Advance care planning is the process of planning ahead for medical care in the event you are unable to communicate your wishes to your family and health care providers. It usually involved at least three steps: 1. thinking through one’s values and preferences 2. talking about one’s values and preferences with family members and health care providers 3. documenting one’s values and preferences, (i.e., advance directive, living will) The best time to make healthcare decisions is before you are ill, when you can carefully consider your options.

Advance Care Plan

Advance Care Plan….

Quality of Life……

Addendum to Permanent Confusion question on Advance Care Plan 11/12/2010 The purpose of this document is to make clear the medical therapies I do and do not want if I am not competent to make decisions for myself. The Lord has given me many gifts during my life. They include two loving wives, two loving children, many grandchildren and a larger family that supports each other. Another cherished gift is our many stimulating friends who love laughter. And finally the gift of relationships with wise patients who taught me about the journey of full catastrophe living and dying. Because of these many blessings I am prepared to face death as an eventual reality. Here are my wishes: Dementia and long term confusion is very common in our family. This illness is a slow devastating process. If I have long term confusion from moderate dementia and am unable to name my grandchildren or you are worried about my safety, I want comfort care only. This means I want pain control and comfort care but do not want treatment for any medical disease such as pneumonia, cancer, heart disease, high blood pressure, diabetes and other infections. The only reason I should be admitted to a hospital is for comfort care or symptom management. No feeding tubes, ventilators or CPR. Period. I expect to be placed in a dementia ward and would appreciate visits no more than three(3) times a week. I hope it is clear from this addendum and my Advance Care Plan aggressive medical care when quality of life is poor is not what I want. Roy O. Elam, III

Treatment……

Other instructions……

Signature and Witnesses……

Notarized in lieu of……

What to do……