Have You Told Someone?
...Let Someone Know.
- Illness or injury can happen at any time.
- Do your family members and loved ones know your health care wishes?
- Would they know what to do?
- Does your doctor know what treatments you do or do not want?
- Have your wishes been recorded? Where? Are they accessible?
Life is a gift . . . beginning with planning, anticipation, and celebration of birth . . . yet often life does not come to an end with the same preparation, expectation, and commemoration. Many are hesitant about discussing end-of-life care issues, especially when time is near. Engaging in conversations with loved ones before there is a need is truly a gift for all involved. How will someone know how to honor you? How will you know how to honor your loved one? . . . unless you have heart-to-heart conversations.
The next step is to record your wishes. One of the best gifts you can give your loved ones is to put your end-of-life care choices in writing so that your family can honor you when you can no longer speak for yourself. Recently, the media has highlighted the importance of medical decisions. Many times, family heartaches could have been prevented had wishes been communicated earlier, before the need arose. It is much easier to have difficult conversations before the stress of illness, accident, or life-altering events occur.
In the spirit of Neighbor Serving Neighbor, HospiceMidland offers education, guidance and support to our community on end-of-life care issues. HospiceMidland is offering “Advance Directives Workshops” to local individuals, churches, and organizations. These workshops are designed to honor faith and cultural facets as they pertain to end-of-life care.
Please consider this an invitation.
HospiceMidland’s goal is to help you understand advance care planning and the process of completing an Advance Directive that communicates your wishes and values about end-of-life care to your health care providers and your family. Please contact Ron Ellison at HospiceMidland at 432.682.2855 or Vicki Jay at Rays of Hope Children’s Grief Centre at 432.684.5437.
Advanced Directives - Definitions
What are advance directives?
“Advance Directives” is a general term that refers to your oral and written instructions about your future medical care, in the event you become unable to speak for yourself. Each state regulates the use of advance directives differently. There are two parts the of advance directives: a living will and a medical power of attorney.
What is a living will?
A living will is one part of the advance directive in which you put is writing your wishes about medical treatment should you be unable to communicate at the end of life. Your state law may define when the living will goes into effect, and may limit the treatments to which the living will applies. States name this document differently; for example it might be called a directive to physician, declaration or medical directive. Your right to accept or refuse treatment is protected by constitutional and common law as well as state law.
What is a medical power of attorney?
A medical power of attorney is a document that lets you appoint someone you trust to make decisions about your medical care if you cannot make those decisions yourself. This type of advance directive also may be called a health care proxy, appointment of health care agent or a durable power of attorney for health care. The person you appoint through a medical power of attorney normally is authorized to speak for you any time you are unable to make your own medical decisions, not only at the end of life.
Why do I need advance directives?
Advance directives give you a voice in decisions about your medical care when you are unconscious or too ill to communicate. As long as you are able to express your own decisions, your advance directives will not be used and you can accept or refuse any medical treatment. But if you become seriously ill, you may lose the ability to participate in decisions about your own treatment.
Who should prepare an advance directive?
These are not just for the elderly. A serious accident could happen to anyone so every adult over the age of 18 should prepare an advance directive. Several landmark legal cases dealing with the rights of individuals to refuse unwanted medical treatments have involved young people under the age of 30 including those dealing with Karen Ann Quinlan and Nancy Cruzan. The case involving Nancy Cruzan was heard by the United States Supreme Court.
Do I need both a living will and a medical power of attorney?
Yes, you can best protect your treatment wishes by having a living will and appointing a health care agent. Each offers something the other does not. The appointment of an agent ensures a more flexible form of decision making. Since the agent can respond to unanticipated changes and base decisions not only on written or verbal expressions of treatment wishes, but also on general knowledge of the patient.
None-the-less, the living will can be very useful for several reasons. If the agent becomes unavailable or unwilling to serve, the living will can serve to guide medical decision making. The living will can reassure the agent that he or she is following the wishes of the principal and ease the burden of decision making. If the agent’s decisions are challenged, the living will can provide evidence that the agent is acting in good faith. Finally, not everyone has someone to serve as a health care agent.
Where do I get these documents?
HospiceMidland has all the necessary forms available at no charge. We will be happy to assist you with understanding the documents. Call Vicki Jay at 432.684.5437 or Ron Ellison at 432.682.2855 or come by Rays of Hope Children’s Grief Centre at 900 west Wall or HospiceMidland at 911 West Texas to pick up a packet.
What do I do with my directives after they are signed?
Make several photocopies of the completed documents. Keep the original in a safe but accessible place (not a safe deposit box). Give the copies to your agent, alternate agent, your doctor and anyone else who might be involved with your health care.
HospiceMidland is a member of the US Living Will Registry and will be glad to register your documents so you may have access to them 24 hours a day, 7 days a week anywhere.
Registering Advance Directives
If you wish to have your documents registered with the U.S. Living Will Registry, please contact HospiceMidland at 432.682.2855 or Rays of Hope at 432.684.5437.
It will be necessary that you bring a copy of your signed documents to HospiceMidland at 911 West Texas or Rays of Hope at 900 West Wall. You will be asked to fill out a U.S. Living Will Registration form.
It is recommended that you register:
DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES
MEDICAL POWER OF ATTORNEY
It is also suggested that you register:
AUTHORIZATION TO RELEASE MEDICAL INFORMATION (HIPPA)
Will my advance directives be honored in another state?
Many states’ laws explicitly honor out of state directives as long as they do not conflict with that state’s own law and other state statutes don’t address the issue. In fact, a state would probably have to honor an advance directive that clearly expressed your treatment wishes, because your constitutional and common-law rights to accept or refuse treatments may be even broader than your rights under a specific state law. However, if you spend significant time in more than one state, we recommend that you complete the advance directives for all of the states involved. It will be easier to have your advance directives honored if they are the ones with which the medical facility is familiar.
Will my advance directives be honored in an emergency?
No. Generally, advance directives such as living wills and medical powers of attorney are not effective in a medical emergency. There is not time in an emergency either to consult the directions in an advance directive or determine a person’s underlying medical condition. Once the person comes under the care of a physician, the contents of a living will can be evaluated and the instructions of a health care agent determined in light of that person’s overall prognosis.
What happens if my doctor (or family) won’t honor my wishes?
There is no simple answer to this question. For this reason it is essential that you have honest and open discussions with your agent, family members and physician about their willingness to support and if necessary advocate to see that your wishes are carried out. If you find they are not willing to support your choices, you may wish to consider appointing a non-family member who will honor your wishes or change your physician before a conflict arises.
If I sign advance directives, will doctors still take care of me if I’m sick?
Yes, a doctor or hospital cannot condition treatment on whether or not you have an advance directive. Even if you decline certain kinds of treatment, you may need care to ensure that you are kept comfortable and free of pain.