Last week, I heard a fascinating story on NPR that really stuck in my head.  And it got me thinking about the "what if's" in my own life.

The story - The Town Where Everyone Talks About Death - is about the town of La Crosse, Wisconsin, where apparently 96 percent of the population have an advance directive or a similar type of document.  Across the country, only about 30 percent of the population have an advance directive.  

La Crosse owes its high rate to one man - Bud Hammes - a medical ethicist at the local hospital who was always the one called in whenever a family was struggling with medical decisions for a family member.  Hammes found that by talking with patients about the wishes for medical care before they needed it, he was able to lessen the decision-making burden on the family, respect the patient's wishes, and - almost accidentally - lower health care costs for the whole community.

Why the lowered health care costs?  Well it turns out, that when you ask people ahead of time, most patients want to stop medical care well before the point where their family members would continue to press on.  Most patients do not want to be kept alive by machines.  And most would not choose medical treatment that would extend their lives by a few months if it meant that they would be a burden to their family for those remaining days.

The time to ask patients about their wishes is well before they get sick.  

All of this got me thinking about my own wishes for medical treatment, as well as those of my loved ones.  But where does one get an advance directive?  And how do you start that conversation with your loved ones without making it sound like you are planning their funeral before its time?  As the NPR piece points out, death is a difficult discussion in this country.

The first step is to make sure you have your own advance directive in order.  Unexpected health situations can happen to anyone, at any age.  So even if you feel invincible now, you never know what tomorrow might bring.  Every state has a blank advance directive form online that you can print out.  In Virginia, you can even create an online account to store your document so that it can be accessed easily.  You can also talk to your health care provider or your lawyer, or ask your local hospital if they have a form you can complete. 

Once you fill it out, make sure your health care provider has a copy, and talk over your wishes with family members.  If you're particularly savvy, this may be the perfect starting point for the second half of this conversation.  Share your wishes, and ask them their own.

You can start by saying, "What if..."

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