Amanda Wilde (Host): End of life planning empowers you and your family by ensuring your medical and financial wishes are known. Next, Krishna Shah, Long Term Care Director of Social Services, guides us through end of life and advanced directive planning. Welcome to Wellness Waves, a podcast from Bergen New Bridge Medical Center. I'm Amanda Wilde. Welcome, Krishna. So good to have you here.

Krishna Shah, LCSW: Thank you so much.

Host: First, let's start with the basics. What is the definition of end of life planning? What does that include?

Krishna Shah, LCSW: So end of life planning is planning for the future, that can make all the difference in an emergency and at the end of your life. Being prepared and having important documents in a single place can give you peace of mind, help ensure your wishes are honored, and ease the burden on your loved ones.

Host: So those are all important reasons to do the end of life planning. How do you codify your wishes. I mean, do you do that through a legal document or more than one? How does that process work?

Krishna Shah, LCSW: So end of life plan can include a conversation with your loved ones, a spouse, a child, a sibling, or any other family member. It can include documentation such as an advance directive, a living will, a healthcare durable power attorney, or a healthcare proxy. There's also financial living wills that can be a part of the life plan, and, there's arrangements that you can make with funeral homes, for a prepaid funeral arrangement as well that can be a part of your end of life plan.

Host: Okay. You used some terms there. I want to go back and understand, living will, advanced directive. And I also want to ask about power of attorney. First, what is a living will?

Krishna Shah, LCSW: So, a living will outlines your preferences for medical care in a life threatening situation or at the end of your life. Having this in place can provide your family an ability to make decisions aligned with your wishes. You can say which common medical treatments or care you would want, which ones you want to avoid, and under which conditions each of your choices applies.

Host: And then there's an advanced directive. Is that part of your living will or is that something different?

Krishna Shah, LCSW: So an advanced directive is also a legal document that covers health care and protects your wishes at the end of your life. This can include instructions for medical care that can go into effect when you can't communicate. And it can also include naming a durable power of attorney for healthcare. This individual would help you make your decisions and follow your decisions.

Host: So, it's important to have someone have your power of attorney if you are not able to make decisions for yourself in advance also.

Krishna Shah, LCSW: It's advisable to do that as that individual can help speak on your behalf when you're unable to. The person can be anyone you trust. It doesn't always have to be a family member, but this person can ensure that your wishes are followed as you might want them to be followed and have it documented.

Host: Yeah, I always wonder how that goes into effect, because we're talking about maybe unforeseen circumstances that we're planning for, so what if something sudden happens, how are your wishes accessed and followed?

Krishna Shah, LCSW: So your wishes can be documented on actual paperwork. It can be on an advanced directive, which can include different aspects of your care. Your loved ones, your family member, your physician, your attorneys, they all can have access to and copies of these things. And to keep a copy on your person is always advisable.

Host: What happens if you do not have an advanced directive or an end of life plan?

Krishna Shah, LCSW: Not having one is not detrimental, but it's advisable to have one. When you don't have an advanced directive or a plan in place, it's very difficult to have exactly what you would have wished for or wanted for yourself to be followed in emergency situations or a situation where quick decisions have to be made and you're not able to verbalize, your family members put in a spot where it might be difficult for them to make such a decision and it can be a life changing decision.

Host: Right. And so, advanced directive or a end of life plan will put you in charge of this possible future, even when you can't communicate.

Krishna Shah, LCSW: Absolutely. It gives you the chance to have what you want put into place like you said even when you can't communicate. Your wishes will be followed.

Host: And it's my impression there are more of these in the past, say, I don't know, half century, last 50 years or so. Is this a more popular option for people? And if so, why? Do they find it's working? I guess that's for the living to figure out if it worked well.

Krishna Shah, LCSW: So the increases in the number of people doing an advanced directive, a living will, a healthcare proxy, is increasing. For that very reason that we discussed earlier. So your wishes, the way you want to be taken care of at the end of your life, or in emergent situations, can be followed. A lot of people want to decide for themselves how they want to leave the world, when it's their time.

So this is the best way to ensure the wishes that you want are followed through.

Host: What are your recommendations to your clients and their loved ones? Are there a few things you always want people to know as they begin this process?

Krishna Shah, LCSW: Yes, I actually have spoken to a lot of our families here. A lot of our residents that we take care of and my own loved ones. And I recommend that everybody, no matter what your age, try to put an advanced directive together and a plan for the end of your life. Things can happen at any time. Situations occur anytime and you want to be well prepared and you want to make sure that your family is aware of your plan as well to avoid putting them in a very, very tough situation.

Host: Well, thank you so much for all this great information, Krishna. And thank you also for your insights and your time and all the work you do to help navigate the process of end of life planning.

Krishna Shah, LCSW: Thank you so much for allowing me to speak on this topic.

Host: That was Krishna Shah, Long term Care Director of Social Services at Bergen New Bridge Medical Center.

For more information, visit newbridgehealth.org. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks for tuning in to this episode of Wellness Waves, a Bergen New Bridge Medical Center podcast.