Illness and death are never easy subjects to discuss. But by planning ahead you can clearly express your wishes and relieve your family of the burden of guessing what you'd want done at a very difficult time. If you are caring for an elderly family member you may want to make sure they do the same.
This planning typically includes preparation of the following:
Living will which spells out the types of medical treatments and life-sustaining measures you want and don't want, such as mechanical breathing (respiration and ventilation), tube feeding or resuscitation. You might think about your values, such as the importance to you of being independent and self-sufficient, and what you feel would make your life not worth living. Would you want treatment to extend life in any situation? Would you want treatment only if a cure is possible? Would you want palliative care to ease pain and discomfort if you were terminally ill?
Health Care Power of Attorney (POA) which designates an individual to make medical decisions for you in the event that you're unable to do so. This individual doesn't have to be a family member but it may be more convenient if he or she lives in the same city or state as you do.
Do not resuscitate (DNR) order is a request to not have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. Resuscitation restarts the heart when it has stopped beating (cardiac death). Consider if and when you would want to be resuscitated by cardiopulmonary resuscitation (CPR) or by an electric shock to stimulate the heart. Mechanical ventilation takes over your breathing if you're unable to do so. Consider if, when and for how long you would want to be placed on a mechanical ventilator.
Each state has its own laws regarding advance directives and you may want to consult an attorney about this process. State-specific forms are available from a variety of websites, such as the National Hospice and Palliative Care Organization.
Once you've filled out the forms, give copies to your doctor, the person you've chosen as your health care POA and your family members and keep a copy in a safe but accessible place.
Nancy Carey, RN
The Geriatric Care Consultants