[Rhodes22-list] Not About Sailing - About Advance Directives!

[Steve Alm]

Nell,

Thank you.  I know people all over the country, like me, are now scrambling
to understand this and prepare the proper documents.  Please explain the
difference between having a Living Will and a Healthcare Power Of Attorney.
Does the former require the latter?  Can the latter suffice by itself?  I
don't understand the difference between a Power Of Attorney and an "agent"
or "spokesperson."  This probably varies from state to state.  (I'm in
Minnesota)  As I understand it, some documents list specific
scenarios/procedures such as respirators, dialysis, surgery, etc. that are
to be expedited or not, and under specific situations.  But of course a
healthy adult cannot predict what may happen, so how do you allow for
something more "open-ended?"

Slim

On 3/28/05 11:54 AM, "Nell" <nellwolfe at cox.net> wrote:

> For All the Rhodes 22 folks out there,
> 
> I have written the following article for submission as a freelance writer.
> 
> I would appreciate your comments please.
> 
> 
> 
> I am an Advanced Care Planning Facilitator. It is my job to help interested
> people in understanding the different methods
> by which they may make their wishes known regarding the extent to which they
> would like to be kept alive in the event that
> they experience an event which renders them in varying degrees of
> incapacitation.
> 
> The first thing the reader should keep in mind is that NO Advanced Directive
> means that family or the courts will ultimately
> make decisions about you based on what they want for you - not what you want
> for you!
> 
> The belief that "everybody who knows me knows what I want in the event I am
> no longer able to speak for myself" is the same
> as leaving it up to family, friends, and the courts. Terri Schiavo is the
> object of a bitter struggle between her husband, her parents,
> and the courts precisely because she left no advanced directives IN WRITING!
> Recollections, reported past conversations, and
> incidental remarks purportedly made by Ms. Schiavo are all that is available
> to attempt to determine what her wishes might be.
> 
> Secondly, it does not need to cost a penny to complete an Advanced
> Directive. Yes, you can formulate a Healthcare Power of
> Attorney or Living Will through an attorney but you can just as easily
> complete such a document whenever you or a loved one
> seeks care at a hospital or medical care facility.
> 
> While the specific names for the documents and some of the details contained
> within the documents vary according to state,
> the essence of making the specifics of what you would like to have done or
> not done when you can no longer speak for yourself
> are similar nationwide. The basis for encouraging the formulation of such
> directives is a respect for individual well-being and
> the right to self-determination.
> 
> In fact, as the result of congressional passage of the Patient Self
> Determination Act in 1991, all health institutions (hospitals,
> long term care facilities, hospices, home health agencies) in all 50 states
> are required to ask all adults on admission if they have a
> written advance directive and document their responses. Further, these
> health institutions must provide written information to
> adults about their right to refuse medical and/or surgical treatment under
> the state statutes and standards and policies of the institution.
> 
> Thirdly, a person may change their written directive at any time.
> 
> To begin to think about what it means to "live well" means that each of us
> may consider our personal values, goals, religious and
> cultural beliefs. In this way we can begin to understand what we envision
> for ourselves as we live out our lives in the best possible
> manner. By making specific end-of-life treatment choices, each of us can
> begin to fashion a plan for "living well".
> 
> It is important to keep in mind that the types of decisions we make are
> greatly influenced by our health status. Healthy adults need
> only to begin to think about what they would like. While considering their
> options, it is important to begin to consider who they
> would like to act as their agent or spokesperson when end-of-life issues
> arise. Conversation with possible spokespersons is very
> important so that the agent knows clearly what the person wants and their
> feelings about types of interventions.
> 
> People with incurable, progressive diseases like cancer, congestive heart
> failure, kidney failure, chronic obstructive pulmonary disease
> need to understand the progression of their disease and treatment decisions
> they may likely face in the future. Knowing some of the
> outcome statistics may help the person better understand the benefits and
> burdens of life-sustaining treatments.
> 
> Patients who are living in long term care facilities or are expected to die
> within 12 months need to begin to consider what they feel
> would be a "good death". In other words, how do they envision living out
> their final months and days in the best way possible?
> It is time to talk about resuscitation - its likely outcome; options for
> withdrawing life-sustaining treatment if the treatments no longer
> serve the purpose of facilitating a "good death"; comfort care - what it
> means to the patient and under what circumstances would they
> want their symptoms controlled even if that meant that death might be
> hastened. 
> 
> Most importantly, everyone owes it to themselves and to their loved ones to
> begin to think about advance care planning.
> Talk to your family, talk to your doctor, talk to your clergy. Ask yourself
> the tough questions, then formulate a plan that reflects
> what you want for yourself. Take the burden of deciding off your loved ones.
> That is the best legacy of all.
> 
> 
> 
> 
> 
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