By Joseph Shega, MD, executive vice president and chief medical officer, VITAS® Healthcare

Sometimes, contemplating an action consumes more time than actually taking action. Understandably, big life decisions are often pondered, but rarely finalized, because of how daunting they can seem.

The same is true for topics that cause some discomfort or may feel far off in the future – like planning for the end of life.

Only 1 in 4 men (24%) have formally documented their end-of-life wishes, according to a 2023 survey commissioned by VITAS Healthcare. Yet, 56% of men said they know what kind of medical treatment they do and do not want at the end of life.

What might be the cause of this discrepancy? According to research, men with serious illnesses are more reluctant than women to talk about their own impending death in clinical settings, perhaps because men don’t want to appear “weak” or “needy” by vocalizing their fears or desires.

However, deciding what type of care you want at the end of life is an act of strength – it can help relieve the burden on family members and caregivers to make critical medical decisions on your behalf.

A worthwhile way to plan for the unexpected and prioritize your health is to make an advanced care plan. An advance care plan helps ensure your end-of-life wishes are honored.

Unfortunately, for many men, there is a stark disparity between thinking about making end-of-life plans and actually documenting them. Fortunately, there are steps you and your doctor, or preferred healthcare professional, can take to start planning now.

4 Steps to Begin Advance Care Planning

Having documentation of your end-of-life wishes provides clarity and direction for care teams and prevents delays in care, meaning more time spent comfortably with loved ones.

So, how do you get started?

  1. Reflect on your values and preferences: What matters most to you in terms of quality of life, medical treatments, how and where you spend your time, and end-of-life care?

  2. Talk to your primary care physician: Physicians are prepared to have advance care planning conversations, discuss options and provide guidance.

  3. Document your wishes in writing: Formally documenting your end-of-life wishes makes it more likely that you’ll receive the care you prefer.

  4. Review and update regularly: Revisit your advanced care plan periodically to confirm it aligns with your current preferences, and continue to check in with your physician at all stages of health.

Why is advance care planning important?

Men are more likely than women to say they haven’t thought about their wishes for end-of-life care, according to the VITAS survey, which is why it’s important for men to seize the opportunity to prioritize their health by making necessary preparations for the future. Physicians can help you make a plan that honors your end-of-life wishes and values, cultural traditions and specific needs.

Having an advanced care plan can greatly improve end-of-life care, protect personal autonomy, provide peace of mind (to the patient and their loved ones). As a physician, I want people to have every tool available to ensure they experience the physical, emotional and spiritual comfort and support they deserve throughout life’s journey.

For many, that can involve hospice, which gives seriously ill patients and their loved ones meaningful time together when the focus of care turns from burdensome, often ineffective treatment to comfort and quality of life near the end of life. And hospice isn’t just for the last few days or weeks of life. Patients with an anticipated life expectancy of six months or less can be hospice eligible. In fact, a recent report from NORC at the University of Chicago found that longer hospice stays result in improved clinical outcomes, improved pain control, reduced physical and emotional distress and is associated with increased satisfaction and quality of life.

Men deserve to be heard and cared for at all stages of life. Talking about end of life and making an advance care plan are important steps that you can take now to prepare for your health and well-being in the future.





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