Creating an Advance Healthcare Directive
An advance healthcare directive is a legal document in which a person specifies what healthcare actions should be taken if they are no longer able to make decisions about what kind of medical care they wish to receive. Guideway includes an Advance Healthcare Directive in our Living Trust package.
- This is a legally binding document that allows you to express your desires about end-of-life care, and it must be followed by the medical team treating you.
- You also will appoint an agent, someone you trust over the age of 18.
- Make sure this is someone who will carry out your wishes—even if it conflicts with their own beliefs.
To be thinking about:
- Sometimes people with terminal diseases prefer not to receive additional life-saving rounds of chemotherapy or other Hail Mary efforts to save them. Rather, they prefer to die quietly at home. This may contradict the wishes of well-meaning family members who want to keep them alive. The patient’s decision takes precedent.
- In most cases, advance directives will come into effect after a patient has fallen into a coma, suffered a stroke, or experienced any medical issue that prevents that patient from consenting to treatment. We always think we’ll be in control and able to articulate our own wishes, but in the case of a sudden stroke or coma, we may be incapable of making any these decisions.
- Those who have been diagnosed with a terminal condition may create an advance directive opting out of “invasive treatment” during the final phases of the disease. It’s important to identify “invasive treatment” here.
- While most people use these documents when they are elderly or already sick, anyone 18 and over can create these contingency plans ahead of a serious illness.
When developing your healthcare directive, include:
- The name and contact details of your agent, the person who will carry out your wishes.
- Your healthcare values and choices. This is where you can talk about Hospice, for instance, if that is one of your choices.
- The medical treatments you will accept or refuse.
- Where you would like to receive care. Will this be in your own community or do you want to be closer to where your children live in another state? If this will be a long-term event, that may be the best solution, and it will be something to discuss with your family.
- Whether/not you are donating your organs or tissues. The need is great, but some people have religious reasons not to be participating in these programs.
- All of these documents must be signed and notarized by both you and your agent(s).
An emphasis on comfort care
A term that has popped up in the end-of-life conversation is “comfort care”. For people who may have gone through a few rounds of harsh chemotherapy, for example, only to have their cancer return, it well may be that they don’t have the strength to continue down this path again.
Instead, they prefer to manage the pain and receive “comfort care”, living out the remaining weeks or months of their lives as comfortably as possible, surrounded by people they love in familiar surroundings. Managing the pain is the primary focus.
Making the dying person more comfortable can be achieved in a number of ways, both medically and through efforts by friends, family and local agencies such as Hospice. It becomes a team effort with a single goal.
One more thing: Besides the signature of you and your agent, it’s a good idea to share your end-of-life wishes with your doctor. Making that person aware of your wishes assures you of having an advocate.
An Emotional Journey for a Daughter, a Mother and the Memory Care Unit
April 16–National Healthcare Decisions Day: Naming a Healthcare Agent