In recent years, there has been tremendous growth in the area of “advance care planning,” also known as “advance directives.” By design, advance directives officially document the type of care that you would like to have if/when you are unable to make decisions or are near death.
When I work with patients and families in the hospital setting, I always cover the subject of advance directives. When I introduce the topic, I am often met with looks of bewilderment and statements like, “I am not that sick,” or “It’s only a minor surgery; I’m sure I’ll be fine.” The common misunderstanding is that advance directives are only for people who are “old,” “sick,” or “dying.” The truth about advance directives is they are for everyone who is living. These documents allow you to personally contribute to your care during a potentially precarious situation in the future.
If you become unable to make your own healthcare decisions for any reason and you don’t have advance directives, your legal “next of kin” (NOK) will automatically become responsible for all decision-making. Legal NOKs can include spouses, children, siblings, and parents. In any case, your legal NOK may not be a person that you are comfortable with in this position. Creating an advance directive prevents this situation from occurring.
In Ohio, there are two advance directive documents that I encourage all adults (18 and over) to complete, regardless of health status or age: a living will and durable power of attorney. Advance directives are completed by the individual for whom they represent. They are not to be completed by family members on behalf of an individual. In order to complete an advance directive, you must be of sound mind and not under any duress or influence. Once finalized, the advance directive goes into effect only when you are unable to make decisions for yourself, as determined by a qualified medical professional and mental status exam.
If you should become terminally ill or fall into a permanently-unconscious state, your living will is used to notify medical staff of your preference for or against life-sustaining treatment in the form of cardiopulmonary resuscitation (CPR) and/or artificially-supplied nutrition and hydration. Within the document, you will name two people to serve as contacts to be notified if this situation should occur. These contacts are not decision-makers. The living will is a document that is specific to you and your wishes; it does not involve the participation of others. In my experience, people generally have very strong feelings about this topic in either direction. It is important to follow your intuition and complete the document however you feel moved.
Durable Power of Attorney/Healthcare Power of Attorney
The durable power of attorney for healthcare is used to designate a person (or people) to make healthcare decisions for you should you become unable to make your own decisions. You are able to identify up to three people. The designated power of attorney will have the ability to act entirely on your behalf, including consenting to treat, arranging admission to a nursing facility, obtaining medical records, and communicating with medical staff.
To review the State of Ohio advance directives as made available by Midwest Care Alliance, click here. They have also developed a workbook to encourage conversations around these decisions and choices called Conversations That Light the Way. If you live outside of Ohio, you may request specific advance directives for the state you live in from the National Hospice and Palliative Care Organization. They provide these free of charge.
I encourage you to review this information for yourself, and share it with your friends and family. Although sickness, end-of-life, and death can be uncomfortable for many people to address, it is important that each person has the opportunity to make these important choices for themselves.
This article was written for the eFuneral Resource Center by Laura Sefcik, MPH, MSW, LISW, Certified Grief Recovery Specialist.® Those thinking about end-of-life should visit eFuneral.com for help researching, planning, and arranging a wide variety of funeral-related services.
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