Advanced Directives

INTRO: If preparing advanced directives for end of life care was not one of your New Year's resolutions, it's not too late to act.

1. WHAT ARE ADVANCED DIRECTIVES AND WHY ARE THEY SO IMPORTANT?

A. Advanced Directives are a series of forms, such as a Living Will, Durable Power of Attorney for Healthcare, DO NOT RESUSCITATE, and Donor Enrollment Form, that allow you to remain in control in a situation where you aren't, and to make your decisions known.

B. Advances in medicine and medical technology save lives, but they unfortunately can artificially prolong life without hope of recovery.

2. LET'S TAKE EACH SEPARATELY. WHAT DOES A LIVING WILL DO?

A. A Living Will allows you to decide, and document in advance, the type of care you'd like to receive if you were permanently unconscious or terminally ill and unable to express your wishes. In 1991, Ohio recognized the right to a Living Will, based on your goals and values and on what is acceptable to you/how you'd want to live following a catastrophic event. (Although 70% of Americans say they'd prefer to die at home, only 22% actually do).

B. Physicians have a responsibility to maintain life if there is hope of recovery. A Living Will simply determines how much life-sustaining treatment you would receive once two physicians say that you will not recover. Although you will not receive care that will artificially prolong your life, you will receive pain management and comfort care until you die a natural death.

3. NEXT IS A DURABLE POWER OF ATTORNEY FOR HEALTHCARE. WHAT IS THE PURPOSE OF THAT FORM?

A. With a DPA for HC, you select a person to make decisions if you cannot. That person will carry out your wishes.

B. You create this form along with a Living Will, because a Living Will applies only in terminal cases or cases in which the patient is permanently unconscious. A DPA can make decisions if you are temporarily unable to do so (for example, if you are temporarily unconscious); however, they cannot override your Living Will.

C. Be sure to pick someone who will carry out your wishes. Talk to your family. If something were to happen to you, the chain of those who would make decisions is as follows: Legal Guardian, DPA, Spouse, Adult Children, Parents, Adult Siblings, Aunts/Uncles.

4. WHAT'S A DNR?

A. A DNR is a Do Not Resuscitate form involving CPR. The law/form was established to help you communicate your wishes to medical and emergency personnel and to also protect medical professionals from liability if they follow your wishes.

B. CPR was never intended to be used on people with expected death due to chronic or terminal illnesses. It was to be used in acute reversible conditions, like drowning, shock, heart attacks, surgeries, etc. Only 15% of hospital patients who receive CPR survive until discharge, and that number drops to 5% with elderly or severely ill patients.

C. Do Not Resuscitate does not mean Do Not Treat. The form states what treatments will be done, including pain relief, comfort, etc. It shows that your medical care will reflect your goals and values.

5. FINALLY, WHAT IS A DONOR REGISTRY ENROLLMENT FORM?

A. This is a form you fill out if you'd like to make any anatomical donations.

6. LET'S TAKE A STEP BACK FOR A MINUTE. WHY ARE ADVANCED DIRECTIVES TRULY IMPORTANT TO CONSIDER AND FILL OUT?

A. There are three main events in life: births, weddings, and deaths. And for some reason, we only prepare for two of these. Just as life has a beginning, it has an end. By completing advanced directives, it simply means that you have prepared for this part of life, and that your wishes will be honored based on your values and goals. You will live out the rest of your life as you see fit. And remember, directives only come into effect when you can no longer express your wishes.

B. It's also the greatest show of love to your family to take away the hardest decisions they would have to make if you cannot. They won't have to guess what you would have wanted you gave them direction. They will have the peace and assurance that your wishes have been honored, and they were able to participate in your care by maintaining your wish to be in control of your life in a situation where you otherwise would not be.

7. WHERE CAN PEOPLE GET MORE INFORMATION?

A. They can call us at the Hospice & Palliative Care Partners to receive two free publications. The first is a guide to conversations with family to make your wishes known. The second is an advanced directive packet. This is a collaborative effort between hospice and palliative care organizations, the Ohio State Medical Association, the Ohio Hospital Association, and the Ohio Osteopathic Association.

CLOSE: Give your family peace of mind and make your wishes known. Quit procrastinating, and call the number that's next to receive free information on advanced directives, and how to talk to your family.