Preparation for our healthcare and medical treatment – making official our advance directives – is one of the most stress-relieving acts we can do for our future selves – so let’s get to it! What does this work include? According to the Mayo Clinic website, “Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself. Advance directives guide choices for doctors and caregivers if you’re terminally ill, seriously injured, in a coma, in the late stages of dementia or near the end of life.”
Susanna Barton, columnist
Mayo Clinic said these documents include:
- A medical or healthcare power of attorney (also called a durable power of attorney for healthcare, a health care agent, a health care proxy, a health care surrogate, a health care representative, a health care attorney-in-fact, or a patient advocate).
- A living will.
- Do Not Resuscitate and Do Not Intubate orders.
- And sometimes a POLST (Physician Orders for Life Sustaining Treatment).
Let’s dig a little deeper into these life-giving directives. A medical or healthcare power of attorney is one of the most important documents to secure. According to HealthinAging.org, a healthcare power of attorney is a document that “allows you to choose a surrogate decision maker (such as a friend or relative) to make your medical decisions if you lose the ability to make them yourself.
You should discuss with your surrogate ahead of time the types of treatment(s) you would or would not want in specific situations so that your surrogate has some guidelines if the need arises. It is impossible to imagine all possible situations but discussing what matters most to you to have or avoid will help your surrogate make a decision based on your wishes.”
The National Institute on Aging defines a living will as “a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment. In a living will, you can say which common medical treatments or care you would want, which ones you would want to avoid, and under which conditions each of your choices applies.”
This is the heart of everything when it comes to how you want to be treated medically as you age. And it also requires a great deal of thought, careful consideration and conversation to ensure the wishes you outline are respected. As is the case with most Grand Planning efforts, communication is the key!
The National Institute on Aging also suggests understanding the critical differences in DNR and DNI orders and how they are activated:
“Do not resuscitate (DNR) order: A DNR becomes part of your medical chart to inform medical staff in a hospital or nursing facility that you do not want CPR or other life-support measures to be attempted if your heartbeat and breathing stop. Sometimes this document is referred to as a do not attempt resuscitation (DNR) order or an allow natural death (AND) order. Even though a living will might state that CPR is not wanted, it is helpful to have a DNR order as part of your medical file if you go to a hospital.
Posting a DNR next to your hospital bed might avoid confusion in an emergency. Without a DNR order, medical staff will attempt every effort to restore your breathing and the normal rhythm of your heart. So, how, when and where do we start preparing all these critical medical directives? Where do we begin alleviating stress and concern for our loved ones? How can we mitigate medical geri-drama once and for all?
The best first step is finding an elder law attorney who can provide and authenticate the necessary forms. If you have an attorney already, ask them to refer you to a specialist or perhaps they can help you themselves. Some of these forms do not require attention from an attorney, but certainly attorneys are familiar with their use and importance.
Once these documents are prepared, seal the deal by promising to execute two final tasks: first, communicate your plans to anyone who will listen, often and with urgency, and second, make sure you have these documents stored in an easily accessible and portable place.
Being your best medical advocate and taking an active role in preparing for your healthcare decisions – and most importantly, TALKING ABOUT IT ALL – fosters a collaborative relationship with healthcare providers and families that can make hard choices more manageable. By staying informed and communicating openly, we can enhance our quality of life and navigate sunset strolls with confidence and dignity.
