Kim Elliott, RN, Expert on Healthy Aging

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17 April 2017

advance care directives

Most people are exceedingly uncomfortable talking about the end of life and it’s understandable, of course. Our society emphasizes youth and anti-aging, which further discourages thinking about later life, let alone planning for it. However, it is crucial to make decisions about your wishes before it is too late.

Although there are some signs that talking about death is becoming more socially acceptable, advance care directives which let you plan and communicate your end-of-life wishes, are not even on the radar of many Americans. A study published in The American Journal of Preventive Medicine shows that almost three-quarters of respondents to a survey did not have advance care directives, which are a living will or a durable power of attorney (POA) for healthcare.

This means that if they were incapacitated due to an accident or medical crisis, their family and/or physician would be forced to decide what type of life-sustaining treatment they would want.

An advance care directive is especially critical for people who want to avoid aggressive treatment. Without a clear written direction, chances are high that the medical team will pull out all stops to save your life – even if the side effects of the treatment are severe and you will likely only live for a few more weeks.

Living will
A living will describes under what conditions an attempt to prolong life should be started or stopped if you had a life limiting illness or were permanently unconscious. Before you prepare the document you must give some thought to the kind of life-sustaining treatment you want. For instance, if your heart stopped, under what circumstances, if any, would you want to be resuscitated by CPR? Would you want to be placed on a mechanical ventilator? If so, under what conditions and for how long? Would you want to treat infections with antibiotics or would you rather let them run their course?

Durable POA for Healthcare
Because you can’t anticipate every possible healthcare situation that could crop up, a living will has limitations, which is why I recommend you create a durable Power of Attorney (POA) for healthcare in addition to, or instead of, a living will. This legal document lets you authorize a proxy (POA) to make all your healthcare decisions if you no longer can. In addition to the legal documents, it’s crucial that you have at least one conversation with your proxy to clearly explain your values, beliefs and quality of life wishes.


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