Advance Directives

Who is in Charge of Your Life?

You may be thinking that this is the last topic about which you want to hear or read. Actually, advance care planning is one of the most important things you can do for yourself and for your family. Planning for the last stage of life allows us to make informed choices and to share our wishes with our health care professionals and our family. This step allows us to maintain control, achieve peace of mind and assure that our wishes are honored.

Years ago, physicians were the ones who were mainly responsible for determining how aggressively to treat patients at the end of life. We have come a long way in recent years. Patients are now well informed regarding their conditions and prognoses. We are educated about the normal progression of our illnesses and we are aware of the available options for care and treatment. With professional assistance from our medical team, we are able to make informed decisions regarding this last stage of life.

When we are relatively young and in good health, we may question the need to have Advance Directives. Unfortunately, we never know when a medical event such as a terminal illness or disease may occur. A stroke, heart attack or an accident may cause a life threatening situation, leaving us unable to voice our wishes for care and treatment. Providing end of life treatment to a person who has not conveyed her/his wishes regarding these circumstances places a tremendous burden on families and medical teams.

You may wish to consider the following Advance Directives.

The New York State Living Will allows you to state your wishes regarding medical care in the event that you develop an irreversible condition which prevents you from making your own medical decisions.

The Health Care Proxy allows you to appoint someone you trust to convey your wishes, such as a family member or close friend, if you are unable to do so. The designated Proxy needs to be fully informed of all your healthcare decisions.

The MOLST (Medical Orders for Life Sustaining Treatment) form is a relatively new directive. This directive is a more detailed and specific form for care at the end of life. It is completed by your physician and you, often in the later stages of life or for a more serious medical condition.

The DNR (Do Not Resuscitate) order is used to decline resuscitation when your condition does not allow for any reasonable hope of recovery. This order is used when it is determined that resuscitation would only prolong the dying process.

I have just briefly outlined Advance Directives and the importance they play in our lives. To be fully informed, you need to discuss them with your healthcare team and your family before you make decisions regarding your personal treatment. It is also important to understand that any of these directives can be updated and changed as your situation or your wishes change.

This may be an uncomfortable topic for some individuals. However, as I mentioned earlier, it may be the best gift you can give to yourself, your family and your healthcare team. Advance Directives ensure that you will have control over one of the most important stages of your life.

As Administrator of the Farrar Home, it is one of the discussions I have with our residents during the admission process. Over the years, we have seen that our population is more informed. Now, it is rare for a resident not to have Advance Directives in place. I completed my Advance Directives a few years ago. It gives me great peace of mind that my wishes are known and recorded. It is also reassuring to me that my family will not be burdened with difficult decisions during a stressful time.

I wish you good health and happiness as we continue to work to make our lives the best they can be.

Carol McKee, RN, Administrator of the Farrar Home