Mr. Bill is a vibrant 85 year old who loves his family, his yard, an end-of-day beverage, and his independence. A proud survivor of the great depression and WWII, he can grow anything, build anything, fix anything. Mr. Bill has a living will and strong opinions on “not being kept alive by machines.” When Mr. Bill suffers a catastrophic event, his living will provides clear direction for his family and his health care team. Right?
As an ED nurse, home health nurse, Director of Quality Management, educator, POA and daughter of Mr. Bill, the answer to the above question is a resounding NO. Mr. Bill’s advance directive stated that no extraordinary measures were to be used to prolong his life, specifically prohibiting CPR and artificial respiration. What about assisted breathing or massive doses of antibiotics with debilitating side effects? What about a feeding tube or parenteral nutrition, and in this age of evolving technologies, who defines “extraordinary”?
Advance Health Care Directive (Living Will)
A living will or advance health care directive is the primary legal tool for protecting a person’s healthcare wishes if and when they can’t speak for themselves. Should a living will provide clear direction about healthcare wishes? Absolutely, yes, it should! However, a living will is only as good as the planning and thoughtful consideration that goes into its formulation. Additionally, plans, wishes, thoughts, and feelings about end of life may change with age. What you, your loved one, or those you care for envisioned at age 50 can be vastly different from the vision at age 85.
Advance care planning is much more than asking, “Do you have a living will or other advance directive?” “Advance care planning may be the single most important action you can take to advocate for the rights of those you love and those you serve,” according to Paul Malley, President, Aging With Dignity, a national nonprofit organization and developer of America’s most popular living will, Five Wishes.
As a caregiver, learn to have difficult conversations surrounding end-of-life issues. Listen and help those you love or care for to express their wishes. Help them put their wishes in writing, using a legally valid document, and above all, encourage the sharing of these wishes with extended family and the health care team. Remember to revisit the legal document periodically, as wishes may change over time.
Advance Care Planning Series
Relias, in partnership with Aging with Dignity, is developing a three-module advance care planning series dedicated to helping those in the health care setting. Modules will focus on understanding the overall purpose and advantages of advance care planning, providing scenario-based learning and other tools designed to help caregivers have difficult conversations, and designing and implementing an advanced care planning program in your clinical focus area.
Remember, advanced care planning is a gift – a gift of dignity, a gift of clarity, a gift of peace. Be the person who brings this gift to your loved ones and those you serve.
Watch our on-demand webinar to learn more on effective and compassionate commuinication around advanced care planning with Aging with Dignity’s President, Paul Malley, and Five Wishes Healthcare Advisor Kathleen Taylor.