Home End of Life issues Advance Directives: Making Your Wishes Known

Advance Directives: Making Your Wishes Known

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An advance directive is a legal document that allows you to make your medical/healthcare wishes known to your family, friends and medical personnel in the event you become unable to make decisions for yourself. (ex: stroke, coma,) and you are unable to express yourself. These documents can be put into place as early as 18 years old. This allow you, as an individual, to make your health decisions ahead of time. It also takes the stress off family members to make those decisions for you. For a good example of why this is important, look at what could happen if you don’t have this emergency information.

A good advanced directive describes the treatments you would want or do not want depending on how sick you are.

A clearly written advance directive helps prevent disagreements among those close to you and alleviates some of the burdens of decision making which are often experienced by family members, friends and health care providers. Should you have an illness where you are unlikely to recover, or have a condition you feel affects your quality of life, you have the right to be specific about the certain kinds of treatment you do not want. On the other hand they can also say that you want a certain treatment no matter how ill you are.

Advance directives take many forms and each state is very different. You may change or cancel your advanced directive at any time, as long as you are considered of sound mind to do so. That means you are able think rationally, and communicate your wishes in a clear manner.

There are times when you do not have time to put things in writing. Maybe you have a sudden change in your health and you are faced with a sudden change in your condition. You should express to your doctor and your family exactly what your expectations are at this time. Wishes made while in the hospital will be followed and override anything made in writing by you earlier.

Individuals who are seriously or chronically ill are more likely to have an advanced directive. They may choose to not allow CPR ( cardiopulmonary resuscitation) should their heart stop or they stop breathing. One may choose not to be placed on a ventilator or be treated with IV antibiotics that may prolong their life. These decisions when made ahead of time, can reduce suffering, and give an individual a sense of control over their quality of life decisions and death. End of life issues can be overwhelming , but it does not have to be a negative experience. Death can be a time for families to come together, share, celebrate a life and love of a family member.


What is a living will?

A living will is a form of an advance directive. This document frequently outlines specific types of life sustaining treatment you may or may not want. The requirements of a living will vary from state to state, so make sure you consult a professional who has expertise in this legal area before you decide to create a living will.

Talking with your doctor or healthcare providers about your end-of-life wishes is a discussion to have before a crisis occurs
Download our Free guide to talking with healthcare providers


End of life issues

In completing the cycle of life, death is a subject everyone wants to avoid. It is a subject that when approached should include preserving one’s preference and dignity at the end of life. Many do not know the questions to ask when it comes time for making end of life decisions.very sick man

Communicating your wishes in a detailed manner will make it easier for everyone to respect your wishes. You should be aware that just having a written directive by itself does not ensure that your wishes will be honored or respected. Studies show that many advanced directive forms do little to influence end of life decisions unless there was personal communications between you and your family, your health care professionals before a crisis occurs.
First, it is important to consider your values and the things that are important to your quality of life. What do you value most about your physical and mental well being? Consider things such as do you love reading, listening to music, being outdoors, gardening, seeing, tasting, cooking, painting, talking sports or politics.

Do you have fears regarding dying? If you knew that in the very near future your death was inevitable, envision where you would want to be, who you would want to be with you.
Think about what you would want to say to those around you. Think about what you may need for comfort and support. You may want someone to read to you, pray with you, have your favorite music playing. These are important issues you should discuss with your family, friends, and your spiritual counselor.

Today, there are many treatments that keep people alive even though there is no chance their condition will reverse or the condition will improve. Many times families continue medical treatments long past the point where they are helpful, simply because they did not know what their loved one wanted and feel they must do everything possible. This takes an unnecessary emotional and financial toll on a family.

Take time and review these situations and consider what is important to you and your quality of life. If there was no chance of improvement do you want treatment or do you definitely not want to endure a treatment that might keep you alive.

In considering a treatment, you really need to address what you are willing to endure if the chances of regaining your current health and current quality of life were high. If the chances are low that your condition or quality of life will not be the same or better, you should assess your willingness to take these risks.


Here are a few scenarios that you should give some thought to:

You are seriously ill and the treatments proposed have severe side effects.These side effects (nausea, vomiting, diarrhea, pain, weakness, inability to eat, constant fatigue) may last for months or become a permanent condition. What would you be willing to endure if the doctor could assure you that you would regain your current quality of life and health.?

You have a sudden condition where you can no longer express yourself verbally?

You have a condition that affects your swallowing, and you are unable to eat?Your only option is a feeding tube for nutrition. You would never be able to eat regular food again. You have to have a tube placed in your stomach to allow your stomach content to empty into a bag, because your condition causes constant vomiting.

You are no longer able to speak clearly or follow commands.

You are in severe pain most of the time.dialysis machine

You have a lung condition that limits your physical abilities so you are unable perform anything without getting out of breath. You may require being placed on a ventilator to assist with breathing.

Suffer from severe nausea, constant diarrhea, vomiting, dehydration or constipation.

Your present condition is causing you to have repeated and frequent admissions to the hospital.

Your present condition requires that you be on a dialysis machine several times a week in order to stay alive.

You require someone to assist in caring for you 24 hours a day.

You can no longer spend any time out of the house.

Your presently have severe pain and in order to have it alleviated, the meds you take make you sedated and cause you to sleep all the time.

These are very important aspects of end of life issues that will help you take charge of your life, even until your death. Planning ahead and good communications will make it easier for others to respect your wishes. It helps your family and friends to make those difficult decisions with less anxiety and regret or guilt.

If all this is overwhelming for you it may be the right time to take a look at how the Health Care Notebook makes it easy for you to compile all this information and keep it in one place.

Caregiver Relief will continue to provide important information help for those planning to age in place.