[Rhodes22-list] Not About Sailing - About Advance Directives!

[Nell]

For All the Rhodes 22 folks out there,

I have written the following article for submission as a freelance writer.

I would appreciate your comments please.

 

I am an Advanced Care Planning Facilitator. It is my job to help interested
people in understanding the different methods
by which they may make their wishes known regarding the extent to which they
would like to be kept alive in the event that
they experience an event which renders them in varying degrees of
incapacitation.

The first thing the reader should keep in mind is that NO Advanced Directive
means that family or the courts will ultimately
make decisions about you based on what they want for you - not what you want
for you!

The belief that "everybody who knows me knows what I want in the event I am
no longer able to speak for myself" is the same
as leaving it up to family, friends, and the courts. Terri Schiavo is the
object of a bitter struggle between her husband, her parents,
and the courts precisely because she left no advanced directives IN WRITING!
Recollections, reported past conversations, and
incidental remarks purportedly made by Ms. Schiavo are all that is available
to attempt to determine what her wishes might be.

Secondly, it does not need to cost a penny to complete an Advanced
Directive. Yes, you can formulate a Healthcare Power of
Attorney or Living Will through an attorney but you can just as easily
complete such a document whenever you or a loved one
seeks care at a hospital or medical care facility. 

While the specific names for the documents and some of the details contained
within the documents vary according to state,
the essence of making the specifics of what you would like to have done or
not done when you can no longer speak for yourself
are similar nationwide. The basis for encouraging the formulation of such
directives is a respect for individual well-being and
the right to self-determination.

In fact, as the result of congressional passage of the Patient Self
Determination Act in 1991, all health institutions (hospitals,
long term care facilities, hospices, home health agencies) in all 50 states
are required to ask all adults on admission if they have a
written advance directive and document their responses. Further, these
health institutions must provide written information to
adults about their right to refuse medical and/or surgical treatment under
the state statutes and standards and policies of the institution. 

Thirdly, a person may change their written directive at any time. 

To begin to think about what it means to "live well" means that each of us
may consider our personal values, goals, religious and
cultural beliefs. In this way we can begin to understand what we envision
for ourselves as we live out our lives in the best possible
manner. By making specific end-of-life treatment choices, each of us can
begin to fashion a plan for "living well". 

It is important to keep in mind that the types of decisions we make are
greatly influenced by our health status. Healthy adults need
only to begin to think about what they would like. While considering their
options, it is important to begin to consider who they
would like to act as their agent or spokesperson when end-of-life issues
arise. Conversation with possible spokespersons is very
important so that the agent knows clearly what the person wants and their
feelings about types of interventions.

People with incurable, progressive diseases like cancer, congestive heart
failure, kidney failure, chronic obstructive pulmonary disease
need to understand the progression of their disease and treatment decisions
they may likely face in the future. Knowing some of the
outcome statistics may help the person better understand the benefits and
burdens of life-sustaining treatments.

Patients who are living in long term care facilities or are expected to die
within 12 months need to begin to consider what they feel
would be a "good death". In other words, how do they envision living out
their final months and days in the best way possible?
It is time to talk about resuscitation - its likely outcome; options for
withdrawing life-sustaining treatment if the treatments no longer
serve the purpose of facilitating a "good death"; comfort care - what it
means to the patient and under what circumstances would they
want their symptoms controlled even if that meant that death might be
hastened. 

Most importantly, everyone owes it to themselves and to their loved ones to
begin to think about advance care planning.
Talk to your family, talk to your doctor, talk to your clergy. Ask yourself
the tough questions, then formulate a plan that reflects
what you want for yourself. Take the burden of deciding off your loved ones.
That is the best legacy of all.