Pipe smoking not encouraged. Nor is using a typewriter. Or wearing that hideous lime tie. Get your act together, sir.

End of life planning. Keep it simple.

As a writer, I love flowery language. I adore a snappy turn of phrase. I like making the reader think, both about what I write and about how I write it.

The problem? Too many documents are more complicated than they need to be. I believe there is no need for that. Especially in health care. And in particular in end of life care.

You see, it turns out that everybody dies. You. Me. That guy over there. The lady smoking a cigarette. We all die. And as a result, we all need to have our affairs in order at the end of our lives. People who die include university language professors. It also includes people who can barely read.

If we’re not talking to everybody, we are talking to nobody.

I went to the American Academy of Hospice and Palliative Medicine conference last week. One of the big topics up for discussion at this conference was how to get people to plan for their end of life. A big barrier here is basic medical literacy. Or even just actual literacy.

Putting advance care planning on the agenda

It is exciting for us when Advance Care Planning ends up as a topic on Forbes, as it did a week ago. It is especially exciting when it is an article written by Charles Sabatino. He writes with incredible insight. It is easy to understand why. Charles is the director of the American Bar Association (ABA) Commission of Law and Aging. He knows this world inside and out.

I agree with the article he wrote for Forbes. He lists four reasons why people fail to plan. I have heard every one of them. When he says that the best advance care planning tools are on the ABA website, we felt compelled to go take a look. Unfortunately, the ABA falls into the same trap as many other lawyers do. Simplicity isn’t their strong suit.

When you go to the page Charles recommends, you find a wall of text. The page that is the best fit for you and me is the ABA’s Toolkit for Health Care Advance Planning. This page starts with an introduction passage that is hard to read:

104 words, but only 3 sentences. Extremely complicated structure. Passive tense.
The document itself is better than the ABA website. But not by much. Hemingway Writer things you need a Grade 13 reading level to be able to read it.

I ran the above passage through the tool many writers use to make their writing more accessible. It is called Hemingway Writer.

Hemingway Writer reports that that single paragraph has a “20th grade reading level”. In other words, you have to be pretty smart and well-educated to understand it.

The real world is different. In the real world, you find people like me, who have English as their third language. You have people who are dyslexic. There are those who just hate reading. Most important: There are people who dread thinking about death. They will use any excuse to skip the topic. Having a complicated document to read is one of those excuses.

Keep it simple.

Don’t get me wrong. The ABA and us are on the same side. We both want as many people as possible to make their end of life plans. We want you to create an advance care plan. We want you to talk to your loved ones about your wishes. And we want you to choose the people who can speak for you when you can’t do that yourself.

We also need each other. The lawyers need companies like LifeFolder to help reach more people. LifeFolder needs lawyers to make sure that everything we do follows the law. We can learn a lot from each other.

I think as an industry we can do better. Healthcare is too complicated as it is. We need to make sure that documents are accessible to everyone.

I believe that if we’re not talking to everybody, we are talking to nobody. It is our duty to make sure that everyone has a fighting chance to be part of the conversation. Using simple, accessible language is an important part of that.


I just know you were wondering. This post is at a 4th grade reading level.


LifeFolder is on a journey to discover how people think and talk about death. Interested? Stay in touch.

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