Plan in advance and tell people if you want to control your dying

A Dr Schillerstrom, writing on a news blog, makes a good point about the psychology and ageing and end-of-life planning. He says:

Perhaps some elders’ reluctance to engage in end-of-life planning stems from knowing that perfectly thought-through wills and living wills do not necessarily decrease death anxiety. It may even increase it by forced confrontation with one’s mortality. However, end-of-life planning may decrease the anxiety of those we love, and it may give some sense of control over the process.

My blog on social work and end-of-life care often puts the case for planning for care at the end of our lives. And the questioning doctor is right, this is often not an easy thing to do.  But if we want to be in control, or a bit more in control if it's at all possible, good advance planning and telling people what we've planned gives us the best prospect of having it like we want it to be. If we don't plan and we don't tell anyone, how are they going to know what to do when we're clog-popping.

The link to the article on the psychology of ageing and end-of-life planning.

Link to my social work and end-of-life care blog.

Balance autonomy & physical/psychological security for older people leaving hospital says study

An interesting article in the Scandinavian Journal of Caring Sciences, at least judging by the abstract, and here was me saying earlier, don't trust the summaries go to the originals). It's from Australia. They studied the difference between older people's views of discharge planning before anything happened, their relatives and healthcare professionals, using a vignette of a frail older person in hospital.

The older people went for the safe option - the care home and so on - for the person in the vignette, but not themselves. The younger people balanced autonomy with security, provided the older person was mentally capable. Discharge planners are advised to stress balancing autonomy with security when working on the issue, look at the ethics of balancing physical with psychological security and help middle-aged people to plan in advance. Sounds like good advice, but I can only see the abstract - this isn't a journal I get.

Linley A. Denson, Helen R. Winefield, Justin J Beilby Discharge-planning for long-term care needs: the values and priorities of older people, their younger relatives and health professionals. Article first published online: 13 APR 2012 DOI: 10.1111/j.1471-6712.2012.00987.x