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Planning for the End of Life
July 15, 2005

As contentious and divisive as the spring 2005 Terri Schiavo case might have been, most people agreed on one thing: a clearer idea of Schiavo's end-of-life wishes would have made things a lot easier for everyone involved.

Calvin College professor of nursing Karen Vander Laan is one of those people.

"A critical care situation," she says, "is too late to be talking about what the person would have wanted."

Prior to coming to Calvin, Vander Laan worked in several critical care situations and saw first-hand how raw such situations could be.

So, while she says the Schiavo case was a sad one, she also wants to use the awareness raised by the case to help people better understand their own possible end-of-life scenarios.

Vander Laan is working with the Capital Area Health Alliance (CAHA) Advance Care Planning Coalition in Lansing, which is part of the national Respecting Choices network of ACP Facilitators, to make people more aware of the importance of advance care planning (ACP).

To that end she is available to present ACP information programs to any community group.

Already she will give presentation on advance care planning on July 20 to the Rotary Club and on August 10 to a Christian businessmen's association.

She is also offering a workshop to train parish nurses and other members of local faith communities to become ACP Facilitators. This two-session workshop is being sponsored by the Grand Rapids Area Health Ministry Consortium and will be held September 15 and September 22 from 6 to 10 pm at Wesley Park United Methodist Church.

"To their credit," she says, "parish nurses in Grand Rapids asked for information on ACP. They want to become ACP Facilitators; they want to help people understand these issues and help them face some of these tough questions before the situation becomes critical."

Some of those questions, Vander Laan, says are fairly obvious. Others are more subtle.

"Does the family of a loved one know what that person would want is a pretty basic question," says Vander Laan, "but an even more important question is whether or not that person's wishes have been discussed and written down. Beyond that there are questions people need to think about such as who would be the best person to make decisions if they are unable to speak for themselves."

The upcoming sessions will cover such questions, looking at potentially confusing topics as wills, living wills, power of attorney, legal guardian, health care agent and more. Those sessions also will deal with more philosophical concerns: what does it mean to live well and who or what sustains people when they face serious challenges in life.

Vander Laan says the reality is that people often don't talk about what their end-of-life wishes are. They avoid the subject. Or if it does come up it's often not pursued to the point where a person's expressed wishes are committed to paper.

"Advanced Care Planning," she says, "is really an ongoing process that involves understanding, reflecting, discussing and then formulating a plan for end-of-life care preferences. It is a topic for every adult of any age and any health status, for now and for later.