Do you have an advance directive? What kind of medical treatment would you want if you were too ill or hurt to express your wishes? What if a close family member were in that situation?
Advance directives are legal documents that allow people to convey their decisions about end-of-life care ahead of time. They provide a way to communicate a person’s wishes to family, friends and health care professionals, and to avoid confusion later on. Sometimes a person is lucid enough to make her own decision.
On March 7 my 84-year old aunt was admitted to the hospital with serious pulmonary issues. After several days, she decided it was time for her to die and requested that her doctors stop therapeutic interventions. As hard as it was for her family, they honored her request. Last year she lost her husband of almost 65 years. It took a heavy toll on her, despite all the attention she received from her devoted sons, daughters-in-law, grandchildren and great-grandchildren.
My aunt was alert, rational, and determined that she did not want to go on living. She called her family to her bedside and expressed her wishes. After several days of saying her goodbyes, she passed away peacefully and with dignity on March 11.
Some people may not be so comfortable with allowing such a decision to occur. That’s why advance directives are so important. If my aunt had not written her wishes in advance, it would have been much more difficult for her children to accept them.
Advance directives tell how you feel about care intended to sustain life. There are many issues to address, including
- The use of dialysis and breathing machines
- If you want to be resuscitated if breathing or heartbeat stops
- Tube feeding
- Organ or tissue donation
Of the many websites explaining advance directives, I found one extremely helpful: Caring Connections, a program of the National Hospice and Palliative Care Organization dedicated to improving care at the end of life. They give a detailed description of advance directives and how to prepare and store them. They also have instructions for downloading one for your state.
Talking about end-of-life issues can be difficult, especially if you’re in the midst of dealing with them. Fortunately, my aunt had expressed her wishes before she went into the hospital. But that didn’t make it any easier for my cousins. Don’t put off having this discussion with your family. There’s an excellent section in Caring Connections on how to talk to your loved ones about end-of-life issues.
Sharing your end-of-life care decisions with your loved ones will also help them ensure your wishes are followed. Caring Connections advises that you
“Reassess your decisions over time. These are not simple questions and your views may change. It is important that you review these issues and discuss your choices as your personal health or circumstances change your life.”