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By Trish Belan
Special to the Rappahannock News
Recently, a very personal family issue made national headlines and highlighted the importance of advance directives, but little information was published on how to go about creating such plans. Living wills, a healthcare power of attorney — forms of advance directives — are critically important. Advance directives go into effect only when a person cannot communicate, and give family members and medical personnel details of what procedures and treatments the person is willing — or unwilling — to undergo.
It is important that advance directives be specific. For example, the vague “take no heroic measures” leaves doubt as to what the person considers “heroic.” A clearer description might include goals, such as being able to breathe, eat, and communicate, and allow treatments or therapies to make those goals possible; and at the same time, stipulate that if achieving those goals seems unlikely to the medical professionals, they should not be instituted, or provide a time frame in which such measures should be tried. A person should also consider whether or not invasive measures, such as chemotherapy, surgery, feeding tubes, or respirators could be used to reach a better quality of life, and when those measures should cease or not be used at all. An advance directive can also specify if the individual would prefer to remain on life support indefinitely if rendered uncommunicative through accident or illness, and designate choices for organ or tissue donation in the case of death.
“The end of a life is never easy, “ said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization (NHPCO).
“Talk now, before a crisis, to ensure that conflict about end-of-life treatment decisions doesn’t happen to your family”
Those people who do not make their wishes known may find those decisions being made by someone else, and it may be a stranger. End-of-life care conversations and documents do not have to be done in a lawyer’s office, but can take place around the kitchen table or in the family room, during calm times, not in the midst of a healthcare crisis.
Hospice of the Rapidan offers the following guidelines to prepare an advance directive, a five-part process related to decisions about future medical care:
1. Before putting pen to paper, you should understand your right to make choices about treatments — what you do or don’t want, and under what conditions — your right to change your mind, and your right to choose someone to speak for you if you can’t. You should also take into consideration your current health condition and lifestyle habits, and be prepared to review your advance directives as your life and health change. Recognize the difference between curative treatments, such as chemotherapy
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