Some people just won't talk about it – as if avoiding the subject of death will make it go away.
In fact, only about one-third of all Americans have filled out a living will or advance directive regarding medical treatment and end-of-life issues, says Dr. David Casarett, chair of the American Geriatrics Society Ethics Committee.
“And this is something that's particularly important for seniors to address because they tend to have chronic medical conditions that might put them in a state where someone has to make difficult health care decisions,” he says.
Health care providers need guidance on some common medical questions, he says.
Among them: If you were terminally ill and near death, would you choose to be resuscitated if your heart stopped beating? What medical treatment would you choose if you had a stroke that left you completely dependent upon other people? Or would you want to be kept alive with the help of a respirator?
The time to consider answers to these questions is when you are feeling healthy, Casarett says.
QUESTION: I thought hospitals are required to ask if you have an advance directive?
ANSWER: They are required to ask, but some hospitals find it hard to respond when someone says “no.” Not all hospitals are helpful on this.
But they do have to follow the advance directive if a patient has one?
With some rare exceptions they do honor them.
What does an advance directive tell health care providers?
It is a document that outlines the patient's wishes regarding medical care. It details what kind of medical treatment and procedures a patient does and does not want.
This document is only used when a patient is no longer able to make decisions or communicate the kind of care he or she wants.
The American Geriatrics Society says to talk to family and friends about what level of care you want. What if a person is alone?
Then at the least a living will should be written, although I prefer an advance directive.
A living will specifies the care you want. A durable power of attorney for health care, or advance directive, names the person you want to make decisions for you when you are unable to do so.
It's a good idea to have multiple copies of these documents.
Where do you get these documents?
I recommend the National Hospice and Palliative Care Web site, specifically, caringinfo.org/advancedirectives. They have specific information on every state as well as information on how to fill out the forms.
How do family members react when asked to respond to advance directives?
Making difficult medical decisions about your own health or someone else's is very stressful regardless of how much preparation is done.
However, there are options available to help reduce stress during these difficult times and to ensure that patient's medical wishes are followed.
Do these directives “expire?”
They do not expire, but over time, feelings may change about the kind of treatment a patient does or does not want. If this is the case, be sure to revise the advance directive and give everyone a copy of the new version.
