With All This Talk About Death Panels…

So that everyone knows, there are no death panels in the much discussed health care reform proposals. However, it does provide an opportunity to discuss what most of us would rather not – how do you want to die?

Again, this is not the type of dinner conversation we look forward to having. And it’s not the type of discussion to keep putting off. This is also not just a conversation for the “over 65” club. Any of us could be moments away from a catastrophic accident or illness that leaves us incapacitated. Does your family know your “final wishes?” Do you want to be kept alive even if you have no brain function? Do you want doctors to exercise every medical effort possible to keep you “alive” in the extreme?

Even still, it’s not enough to just have the conversation. There is too much ambiguity and family members are often emotionally-wrecked about having to make those final decisions for you.

Both living wills and advanced directives provide detailed information on your medical wishes when you are unable to make them for yourself. They are in fact legal documents, similar to a will.

According to the Mayo Clinic, living wills are just one part of advance directives — forms that tell your doctor what kind of care you’d like to have if you become unable to make medical decisions.

Advance directives: More than just living wills

Advance directives are written instructions regarding your medical care preferences. Your family and medical professionals will consult these instructions if you’re unable to make your own health care decisions. Anyone age 18 or older may prepare an advance directive.

Advance directives can include:

• Living will. This written, legal document spells out the types of medical treatments and life-sustaining measures you do and don’t want, such as mechanical breathing (respiration and ventilation), tube feeding, resuscitation. In some states the living will may be known by a different name, such as health care declaration or health care directive.
• Medical power of attorney (POA). This is also called a durable power of attorney for health care or a health care agent or proxy. The medical POA form is a legal document that designates an individual to make medical decisions on your behalf in the event you’re unable to do so. These forms allow your health care agent or proxy to use a living will as a guide, but interpret your wishes when unexpected developments aren’t specifically addressed by your living will. The medical POA document is different from the power of attorney form that authorizes someone to make financial transactions for you. If you don’t appoint a medical POA, the decisions about your care default to your spouse. If you aren’t legally married, decisions fall to your adult children or your parents. 
• Do not resuscitate order (DNR). This is a request to not have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. A DNR order can be put in your medical chart by your doctor. Read More.

Yes, this is extremely overwhelming , especially given the difficult to understand terminology. There are a number of resources on the Internet from non-profit and care giving organizations. They actually provide templates to discuss with your family and your doctors.

One in particular is, Five Wishes, a compact valid in 40 states that allows anyone to express how they want to be treated if they are seriously ill and unable to speak for themselves.

According to Agingwithdignity.org, Five Wishes is unique among all other living will and health agent forms because it looks to all of a person’s needs: medical, personal, emotional and spiritual. Five Wishes also encourages discussing your wishes with your family and physician. Learn More.

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