Advance Directives Important to Seniors’ Medical Decisions

November 03, 2015

The advances in medical knowledge and technology have led to an ever-increasing aging of the population. For most, a long-life is great as long as there are no chronic, painful illnesses or injuries that have a severe impact on a person’s quality of life.

Startling Facts about How Americans Die

Based on a poll conducted by Time/CNN back in 2000, seven of ten Americans prefer spending their final days at home. However, according to the United States Center for Disease Control only 25 percent of Americans manage to be at home at their time of death. The rest, numbering over 70 percent, pass in a hospital, long-term care facility, or nursing home. Not only do institutional settings create anxiety for those who are terminal, the costs can be extreme.

Surprisingly, the number of people admitted to the hospital, where they receive expensive Intensive Care Unit (ICU) care or general hospital care they do not want is increasing. Why is this happening? It appears that Americans spend far more time planning a one-week vacation than preparing for the last two weeks of life. While death is a certainty, how we pass is a matter of choice.

The Need for an Advance Directive

The term “advance directives” is a legal term that describes the legal documents that appoint health care decision-makers (should you become incompetent) and also your choices about life-sustaining treatment. When first implemented, advance directives were nothing more than a list of treatments that a patient did not want used to sustain their life.

Following a number of iterations, today’s advanced directives are more concerned with the potential quality of life a person looks forward to if their life continues. Now, advanced directives may offer direction when a patient is incompetent to speak for him or herself. A directive may instruct that no efforts to sustain your life occur unless there is favorable prognosis if you survive.

Favorable prognosis means different things to different people. For instance, one reader may believe that living in a nursing home with a gastric tube for feeding and no ability to ambulate is not what they desire. Yet, another reader may believe that continuation of life is a deeply held religious belief and wants life-sustaining treatment until it is no longer possible.

Complete Your Advanced Directive

It takes two documents to completely ensure your wishes are followed. The first is your advance directive. Most states have downloadable advance directive forms. Download your state’s form here. Give a copy to your doctor(s), and have one copy with you if you go to the hospital to file with them on admission.

The other form you need to fill out is called a durable power of attorney. This document names a trusted family member or friend to make health care decisions for you if you lose the ability to communicate or are suffering confusion. Only name one person as your decision maker – putting multiple people in charge often results in disagreements – so name the person whom you trust the most to enforce your advance directive.

When given the opportunity of dying at home rather than in a medical facility, most folks choose the home. Medicare covers hospice that will provide palliative care – that is care that keeps you comfortable but will not prolong your life.

Dying in the comfort of home is something a majority of Americans want, but do not get. Protect your last wishes with an advance directive and durable power of attorney.

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