When it comes to conversations regarding advance directives, many adults shy away. This can be due to avoiding the discussion of end-of-life or due to the confusion that Advance Directives tend to cause. Be sure to discuss your wishes with your loved ones.
Every adult should have advance directives, especially people with chronic or terminal illnesses, and even those approaching retirement age residing in long-term care facilities. If health care workers help their patients complete advance directives, the workers will be able to more effectively plan for their own care.
The reality is that very low percentages (as few as 50%) of terminally ill people have advance directives for their medical records. Often, little or no discussion takes place among the physician, patient and family regarding the prognosis and its implications for possible future medical scenarios. It is important to get as much information as possible now in order to make informed decisions later.
Patients who have had the opportunity to discuss their wishes with their families and/or physicians tell us that they are less fearful and anxious about their end-of-life care.
Family members who have had the opportunity to discuss wishes with their loved ones believe that they are care workers regarding their loved ones wishes for care. They feel more confident in predicting their loved ones preferences while making decisions. Once they have started the discussion about Advance Directives with loved ones, they find it easier to continue.
What are Advance Directives?
Remember, there are two important parts to Advance Directives:
- First, name someone to make health care decisions for you when you are unable to make your own decisions.
- Second, discuss with your named decision-maker the kind of medical treatment you would or would not want when you are seriously ill.
Chances are, you have already thought about both.
Advance Directives in More Detail
- Who will make decisions for me when I am unable? This person is usually called your Health Care Agent, Surrogate or Proxy, and the form you should fill out with your wishes is called the power of attorney for health care.
- Decide who. Choose someone you trust to carry out your wishes. The person should be someone you know well and will know well near the end of your life. This person should be someone who can think clearly in a crisis, and who will not feel intimidated to discuss your condition with health care professionals. This might not be your spouse or family member; it might be a close friend.
- Talk it over. Discuss your decision with the person you have selected to make certain that he or she is willing to act as your agent. Also, be sure to discuss your decision with your family and close friends to avoid surprises when the time comes for the agent to start making decisions.
- Write it down. Declare your choice for agent in writing. The easiest way to get the forms for your specific state is to log onto this web link: www.caringinfo.org/stateaddownload. All 50 states have provided their advance directive forms and instructions. You can print them out and complete them. In most cases these documents do not have to be notarized, but you will need at least one witness. Healthcare professionals or attorneys are also able to help you complete the forms, but an attorney is not required.
- What kind of medical treatment do I want? This question is often answered in your living will. It describes what quality of life means to you and what types of medical treatment you want to receive.
- Think about it. Quality of life for you may mean being able to ride your bike to the grocery store, or drive your car to see friends. Maybe it means resting quietly and holding your grandchild. Depending on what gives your life meaning, decide whether you would want all methods of life-support even if there was little chance of recovery. In which cases, if any, would you not want life support? Do you want to be kept completely free of pain? Do you want health care workers to try certain medical treatments for a set amount of time to see whether there is a response?
- Talk it over. Talk with your agent, family and physician about what gives your life meaning. They need to understand what you want when you can no longer speak for yourself. If possible, talk about your fears regarding medical treatments, your spiritual beliefs regarding care, and any encounter that you may have had with a family member or friend who had a good or bad experience with life supporting treatments. Think of other possible scenarios and what you want to happen, in the event of a terrible car accident, brain injury or the onset of Alzheimer’s or dementia.
- Write it down. Declare your directions in writing. Although discussion is the most important part of advance care planning, putting your values and beliefs in writing is helpful. There are several tools that help with this discussion. Logging onto www.nationalhealthcaredecisionsday.org is another great resource with forms for all 50 states.
Remember all of these discussions and actions do not have to occur in one day, but it is recommended that you try to set a schedule and stick to it. If you still cannot get started, for your family’s sake, take this article and write across the top, “Dear family, can you help me start to work on this?” Ten years ago after my father passed away, my sister mentioned that the thing giving her the most peace was that he died in his home, in his easy chair with no tubes or wires, exactly as he wanted. We should all be so well prepared.
| This article was written by Margaret Rudnik, President and Owner, M.A. Rudnik, Inc. You can contact Margaret directly at 708.846.7789. |
For additional information regarding this Best in Class Briefing, please contact Mike Madey, Senior Vice President, Medical Arts Insurance, at 630.967.3805 or via e-mail at mike.madey@medicalartsins.com.