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

Rob Lowe rlowe at vt.edu
Mon Mar 28 16:07:03 EST 2005


Nell,
Interesting timing.  I was looking at advanced directives this morning after
the fiasco being played out in the Schiavo case.  Any suggested web sites
you might add to your article? - Rob

----- Original Message ----- 
From: "Nell" <nellwolfe at cox.net>
To: "'The Rhodes 22 mail list'" <rhodes22-list at rhodes22.org>
Sent: Monday, March 28, 2005 12:54 PM
Subject: [Rhodes22-list] Not About Sailing - About Advance Directives!


> 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.
>
>
>
>
>
> __________________________________________________
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