Why Advance Directive Planning Should Be One of Your New Year’s Resolutions

Wife holding comatose husband's hand in hospital

As 2017 draws to a close and seniors and their families welcome in a new year, it is time to take stock of the past and make plans for the future. Highly advisable is to make advance directives a key priority in your health care planning for 2018.

Let’s face it, many of us do not like talking about end-of-life care. Who likes to stare down their own mortality? It is never easy to think about what plans should be put in place if we are seriously ill and cannot advocate for ourselves. However, for those of us who want control over our own health care choices (and that is the majority of us) denial and avoidance over putting advance directives in place must be overcome. The consequences of waiting until we are in the throes of a health care crisis to make serious health care decisions can be severe. They can range from hasty, pressured choices made by well-meaning next of kin who do not know our wishes to a stranger (a court appointed guardian) making decisions on our behalf if we have no next of kin or designated Health Care Proxy (HCP).

The tendency for those not familiar with a person’s advance directive is to default to the most aggressive medical care measures. This can often be disastrous for a frail senior who is seriously or terminally ill with multiple chronic medical problems. Unwanted aggressive medical care in these situations can often have the unintended consequence of increasing pain and suffering with long hospital stays attached to medical life support. Even for those who choose aggressive care measures, it is they or their trusted proxy who should be making these decisions, not uninformed default appointees. Appointing a HCP will also help family members avoid guilt and turmoil by being forced to make “best guess” health care choices, especially if the outcomes end up seriously impacting quality of life. So, start the New Year on sure and solid footing with the following tips on completing your advance directives:

  • Review what your health care goals and choices are and discuss them with a trusted family member, health care professional or friend.
  • Align your choices with appropriate health care directives. Directives can include appointing a HCP, completing a living will, and making your wishes know through a Medical/Physician’s Orders for Life-Sustaining Treatment (MOLST/POLST) form or nonhospital Do Not Resuscitate/Do Not Intubate (DNR/DNI) forms. 
  • Appointing an HCP involves identifying a trusted person who is willing to be your health care advocate when you are temporarily or permanently incapacitated to make your choices known. This could be a spouse, sibling, family member or close friend. Once identified, a discussion should take place between you and the HCP about your health care goals, choices and wishes. A HCP form, which is easily downloaded online is completed and signed by two witnesses. Unlike a living will, no legal counsel is required to execute this form. Once the HCP form is completed, you can have peace of mind that if you are ever in a position where you are unable to make your wishes known, your HCP can speak on your behalf and communicate your wishes. Appointing a HCP is highly recommended even if a living will is in place, as the language in many living wills may not be specific enough to guide healthcare professionals with certain medical treatment decisions. 
  • If you want to outline more specific wishes regarding life-sustaining treatment or resuscitation measures, you should consider completing a MOLST or nonhospital DNR/DNI form. These directives can be very helpful for frail seniors that are battling multiple serious chronic illnesses or terminal diseases and who want to avoid overly aggressive medical care and recurrent hospitalizations.

Remember, when we have advance directives in place, we remain in control over our own health care choices and lives. 

You can learn more about advance directives and long-term care choices here

Written by Anne Sansevero

Categories: Senior Health