Transitioning in to Retirement
Spiritual Health
and End of Life Planning
by Roy O. Elam, III, M.D.
Associate Professor of Medicine
Medical Director, Vanderbilt Center for
Integrative Health
Spiritual Health in the Last Half of Life
“Beginning to Let Go of the Ego”
 Acknowledge Regrets
seek forgiveness
begin to let regrets go
 Celebrate Accomplishments and Successes
begin to let them go
 Seek Council if Letting Go Is Not Leading to Peace
 Know Your True Self
the source of wisdom, service meaning and love
 Contemplative Practice Can Lead to Happiness and Wellbeing.
Advance Care Planning FAQs
What is an advance directive?
And advance directive is a document outlining your
wishes for healthcare, so they will be known in the
event you are not able to communicate those choices.
There are two parts to an advance directive:
1. A durable power of attorney
2. A living will
• What is a durable power of attorney for
healthcare?
 A durable power of attorney for healthcare is a document in
which you name someone you trust to communicate your
healthcare decisions for you if you become unable to make
or communicate those decisions yourself.
• What is a living will?
 A living will documents your written wishes about lifesustaining treatments that are directly related to quality of
life that is unacceptable to you in the event you are unable
to communicate those wishes.
Who Should Have Copies?
 Health care providers and
hospitals
 Health care agent
 Family
Advance Care Planning
Advance care planning is the process of planning ahead for medical
care in the event you are unable to communicate your wishes to
your family and health care providers. It usually involved at least
three steps:
1. thinking through one’s values and preferences
2. talking about one’s values and preferences with family
members and health care providers
3. documenting one’s values and preferences ,
(i.e., advance directive, living will)
The best time to make healthcare decisions is before you are ill,
when you can carefully consider your options.
Advance Care Plan
Advance Care Plan….
Quality of Life……
Addendum to Permanent Confusion question on Advance Care Plan
11/12/2010
The purpose of this document is to make clear the medical therapies I do and do not want if I am not competent to
make decisions for myself.
The Lord has given me many gifts during my life. They include two loving wives, two loving children, many
grandchildren and a larger family that supports each other. Another cherished gift is our many stimulating friends who
love laughter.
And finally the gift of relationships with wise patients who taught me about the journey of full catastrophe living and
dying.
Because of these many blessings I am prepared to face death as an eventual reality.
Here are my wishes:
Dementia and long term confusion is very common in our family. This illness is a slow devastating process. If I
have long term confusion from moderate dementia and am unable to name my grandchildren or you are worried about
my safety, I want comfort care only. This means I want pain control and comfort care but do not want treatment for any
medical disease such as pneumonia, cancer, heart disease, high blood pressure, diabetes and other infections. The only
reason I should be admitted to a hospital is for comfort care or symptom management. No feeding tubes, ventilators or
CPR. Period. I expect to be placed in a dementia ward and would appreciate visits no more than three(3) times a week.
I hope it is clear from this addendum and my Advance Care Plan aggressive medical care when quality of life is
poor is not what I want.
Roy O. Elam, III
Treatment……
Other instructions……
Signature and Witnesses……
Notarized in lieu of……
What to do……