One of the best parts about writing this column is learning about breakthroughs that help readers — and me — grow older more...
One of the best parts about writing this column is learning about breakthroughs that help readers — and me — grow older more successfully.
Today I have the pleasure of writing about one such discovery. Funny, the topic isn’t the least bit sexy or interesting. Yet it’s about two of the most important tools you can have to protect your interests and dignity as you age. And every adult needs them, not just older people.
I’m talking about a new, improved Durable Power of Attorney (DPOA) for Health Care and a Health Care Directive (otherwise called a “living will” or a “directive to physician”), which, together, are called “advance directives.” Created after a year of research by Compassion & Choices of Washington, a Seattle nonprofit that supports, educates and advocates for improved care and expanded choice at the end of life, including, under certain circumstances, the option of a hastened death. These new documents go well beyond the standard fare that’s been available until now. Here’s how they help:
A DPOA for Health Care allows you, while you’re competent, to name someone to make decisions about your medical care in the event you become incapacitated. These could include decisions about surgeries, medications and life support.
A Health Care Directive lets you, while you’re healthy, spell out your wishes about medical care in the event you become terminally ill or develop a hopeless condition and can no longer say what you want done.
As simple and straightforward as these purposes seem, the devil is in today’s details. For example:
• Continuing advances in medical science and technology now make it possible for us to live weeks, if not years, in a persistent vegetative state, even against our wishes. Until now, most advance directives have lagged behind these changes and used vague terminology coined over 15 years ago.
• Whenever there are disagreements among family members about how aggressively to treat someone who’s dying — especially when there’s nothing in writing to express the dying person’s wishes (think Terri Schiavo) — most hospitals and doctors take the safest route and keep the person alive.
• Unmarried couples, gay or straight, have no legal right to make health-care decisions on behalf of their partners unless they’re named in a DPOA for Health Care.
Among other things, the new Compassion & Choices directives:
• Combine the DPOA and the Health Care Directive into one six-page document that’s easy to understand and simple to fill out. Easy-to-read instructions tell you how, and there are helpful “prompts” in the document’s left margins. No attorney or physician is required.
• Section 5, “Why I Am Making This Document,” gives voice to my own feelings, as well as many of my readers’. It says, “I value life very much, but I believe that to be kept alive in certain circumstances is worse than death. I do not want others to substitute their choices for mine.”
• Sections 6 and 7 contain the heart of the document, stating when you do not want life-sustaining treatment, then allowing you to specify which circumstances, for example:
If you’re very old or very sick (“I have lived a long life, and I am ready to accept death when it comes.”).
You’re unconscious and unlikely to recover, unable to think and communicate, probably permanently (think Schiavo again).
You’re in extreme pain that is probably permanent.
You have irreversible dementia, such as Alzheimer’s Disease.
Other circumstances you can describe in the document.
You won’t see all these choices in other advance directives, but the one about irreversible dementia is unique. Nothing in this document allows someone with dementia to commit suicide. However, if a person with dementia experiences a life-threatening condition such as pneumonia or a urinary-tract infection and does not want treatment, it enables her health-care agent to refuse it on her behalf, letting nature take its course.
If, on the other hand, there’s a good chance of being restored to an acceptable quality of life, it allows for the temporary use of life-sustaining treatment.
Finally, the document addresses a person’s wishes regarding comfort care and pain medication, affirming the right to have pain and symptoms relieved even if it hastens the dying process.
Considering one’s end and how it might occur is not the stuff of sparkling dinner conversations. It’s serious and sobering. However, I’m comforted to know the Compassion & Choices documents will allow me to have more of a say in my own death than the advance directives I prepared years ago. It’s a critical element in protecting my future quality of life now, while I’m healthy and able.
For a free copy of Compassion & Choices’ advance directives (with a suggested donation of $5), call 206-256-1636 or toll free 877-222-2816, go online at www.CandCofWA.org or email email@example.com. Compassion & Choices has also created Wonderfile, a unique and convenient way to organize all your end-of-life paperwork, including the advance directive package, for $20.
Liz Taylor’s column runs Mondays in the Northwest Life section. A specialist on aging and long-term care, she consults with individuals and teaches workshops on how to plan for one’s aging and aging parents. E-mail her at firstname.lastname@example.org or write to P.O. Box 11601, Bainbridge Island, WA 98110. More columns at www.seattletimes.com/growingolder/.