Advanced Care Directives & End of Life Planning

We will all die one day.

There, the words are out. Perhaps you, or someone close to you, has had a brush with death. Maybe it was a story in the news. Perhaps it was this website. Initiating a conversation about death can be hard. You don’t want to think about the fact that you will die and perhaps your loved ones don’t want to think about it either. Not talking about death doesn’t make you live forever.

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In some states you can tell your doctor what  measures you want taken to prolong your life. This assumes you are able to tell your doctor. If you can’t make your wishes known sharing your personal beliefs about what makes your life worth living and your views on quality of life vs. quantity of life help your loved one’s to know what you want when you are dying.

Advanced Care Directives

You can name someone as your Health Care Power of Attorney or Health Care Proxy giving them the legal authority to make health care decisions for you if you become unable to make your decisions known. By including Advanced Directives in your Health Care Power of Attorney document you may specify exactly what measures are to be taken in what circumstances. Advance Directives are not all or nothing decisions. You may want CPR if you have a heart attack but not have a feeding tube placed if you have Alzheimer’s disease or other related disorders.

Living Will

In most states, a Living Will is a legal document that provides your medical treatment or Advance Care Directive information to your physician. A Living Will goes into effect when you have an incurable or irreversible illness with no hope of recovery. If there is a small chance of recovery a Living Will may not be in effect. Recovery does not necessarily mean a full return to prior health.

Advance Directive or End of Life Decisions May include:

  • Do you want your life to be preserved for as long as possible?
    • “Do everything” means that if you are dying, anything that might keep vital organs working will be tried—
      • CPR or defibrillation (electric shock) to restart the heart
      • a breathing machine (ventilator)
      • starting dialysis for failing kidneys
      • an IV or feeding tube to provide nutrition
    • Life support is not intended for long term use
  • Do you want life support if it will only prolong your dying?
  • Do you want your pain managed, even if it makes you less alert or shortens your life or is some pain acceptable to be able to remain alert?
  • What do you want done if you are unconscious and it is very unlikely that you will ever become conscious again?
  • Would you want to have a feeding tube surgically implanted into your stomach if you have a progressive illness that will be fatal and is in an advanced stage, and you are consistently and permanently unable to communicate by any means, swallow food and water safely, care for yourself or recognize family and other people, and it is very unlikely that your condition will substantially improve?
  • Do you want your organs donated (either transplant or for research)
  • Do you want to be buried or cremated?
    • You may want to include where you have prearranged your funeral or burial
  • Should the cost of your care be considered when making a decision about medical care?

Why Should I Care?

Discussing what we want done at the end of our life helps our loved ones make informed decisions for us.

Naming a Health Care Power of Attorney that includes specific Advanced Directives ensures that the end of our life will be the same way we lived it-in our own unique way.