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NOW is the time to communicate your health care wishes.

Advance Directives

Advance directives are the key to having your health care wishes respected

We all want our health care wishes to be respected. If you are mentally competent and conscious you can communicate your wishes to your doctors and you have the right to have those wishes followed. However, what if you are ill or injured and lose your capacity to make or communicate decisions? If you have not filled out a health care proxy form, your wishes might not be known or respected.

Too many times we have heard stories about people suffering terribly at the end of their lives and being kept alive by machines, contrary to their health care wishes because no one knew their health care wishes. Now, while you are healthy, is the time to communicate with your loved ones and doctors about your treatment preferences, and to appoint a trusted person to make these decisions for you if you cannot. This is a gift to your loved ones and yourself.

It’s always too early until it’s too late.

Approximately 70 percent of us will lose decision-making capacity at the end of life. For this reason, among others, it is important to complete a health care proxy, designate a health care agent and alternate agent, and communicate your health care preferences. Failure to do so makes it much more likely that decisions may be made by someone you would not have chosen and that those decisions will not be consistent with your wishes. In addition, when no one knows the wishes of a loved one, conflicts can arise. None of us want to have our children or other loved ones disputing what we would have wanted or what is in our best interest.

There are many reasons that people give for not completing advance directives; for example, "I don't save time," or "It's too overwhelming, or "I don't like talking about these things." None of these reasons is good enough. There’s a saying: “It’s always too early until it’s too late.” You never know when you might become unable to communicate your wishes due to illness or injury. Advance directives should be filled out now before it’s too late.

You should discuss with your loved ones what makes life worthwhile and gives it meaning. Decisions concerning life-sustaining treatment are the most difficult for people to make, so you might want to discuss different scenarios to help guide the person making decisions for you as well as other family members. Here are a few examples of situations that might arise that you may want to discuss:

  • If have advanced dementia, are 90 years old, no longer recognize your loved ones and have lost the ability to feed yourself, would you want to be hand fed?
  • If you are terminally ill and in severe, intolerable pain, would you want to be sedated to unconsciousness if that was the only way to control the pain?
  • If you were unconscious and not expected to recover, would you want a feeding tube?

Suggestions for ways to discuss these and other situations can be found on The Conversation Project website, where you can download “Your Conversation Starter Kit”.

There are several advance directives to consider when stating your health care preferences: a living will, a MOLST form, a dementia advance directive, and a DNR. Click here to see their descriptions.

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