Special Health Care Section: Prepare Now For The Unthinkable

by Ronda Lickteig
R-T News Writer
Death and serious illness are things that happen to other people, right? 
Of course that’s wrong. Regardless of how healthy our lifestyle might be or how careful we are to avoid accidents, death is going to come and we can’t control it- at least not completely. But there are ways that we can ensure that we have the maximum amount of control over how and when our death occurs.
With right-to-die issues in the headlines for many years, more and more people are making sure to have health care directives, also known as living wills, in place even when they are in good health. Having that piece of paper available when its needed can ensure that your choices are followed.
“When someone comes into the ER and is having a stroke, or can’t talk and there is no family there, we have no direction on what this person wants, so we have to do it all,” said Kristi Allen, a social worker at Wright Memorial Hospital. “If there is an advanced directive, it’s all right there. It will say ‘don’t do it’ for some things. We need it so we know what you want or don’t want, then no one has to make decisions, they have already been made.”
Mrs. Allen pointed out that the health care directive does not even come into play if the person can communicate their wishes.
“If you can speak, we’ll ask what you want. If you can speak coherently, we’re not even going to ask about it. If not, we’ll ask if there’s a health care directive in place.”
A Durable Power of Attorney for Health Care Choices names the person who is allowed to make health care choices for you when you are unable to make decisions or communicate your wishes. That person would be allowed to:
• consent, refuse or withdraw consent to artificially supplied nutrition and hydration.
• make all necessary arrangements for health care on your behalf, including admitting you to any hospital, psychiatric treatment facility, hospice, nursing home or other health care facility.
• hire or fire health care personnel on your behalf.
• request, receive and review your medical and hospital records.
• take legal action if necessary to do what you have requested.
• carry out your wishes regarding autopsy and organ donation and decide what should be done with your body.
Some of the decisions that should be discussed in regard to what should be withheld or withdrawn include surgery or other invasive procedures, CPR to restart the heart or breathing, antibiotics, dialysis, the use of a respirator, artifically supplied nutrition and hydration (including a feeding tube), chemotherapy, radiation therapy, all other “life-prolonging” medical treatments or surgeries that are merely intended to keep a person alive without reasonable hope of making the person better or curing the illness or injury, and whether or not organ donation is allowed or prohibited after death.
The meaning of “quality of life” is a subject that should be discussed because its meaning varies.
“What is quality of life for one person is not quality of life for another. For some people, if they’re never going to be able to communicate with their kids again, that’s not quality of life,” Mrs. Allen commented. “They also need to decide if they want to die at home, go to a nursing home, be on hospice, just have enough medication to be kept pain-free. These are all things that need to be discussed and put in writing.”
Young people in particular often don’t see a need for a health care directive because they mistakenly believe nothing will ever happen to them.
“First of all, young people think they’re invincible,” Mrs. Allen noted. “They might think, ‘well, I could be in a coma for six months and wake up and go on with my life. Well, a lot happens in that six months and they need to think about that. They won’t just wake up and walk out of the hospital.”
Mrs. Allen said anyone can come to Wright Memorial and complete the Durable Power of Attorney for Health Care Choices and Health Care Choices Directive free of charge. There is a notary on-site who can notarize the paperwork at no cost and the form can be uploaded to the WMH database, making it available to be accessed at Saint Luke’s-affiliated hospitals. In addition to completing a form at WMH, the form can be downloaded and completed at the Missouri Attorney General’s website: www.ago.mo.gov. The original form should be marked as the original, using blue or red ink or some other distinguishing mark. The document should be given to the family physician to be kept with the patient’s medical records. Mrs. Allen said she keeps a copy in the glove box of her car.
“If it’s in your safe deposit box at the bank, it’s not doing you any good.”