End-of-life wishes: making yours known is the greatest gift

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Wednesday, February 28, 2018 05:36PM
RALEIGH - Regarding issues of your health, who would speak for you if you could not speak for yourself? Would the person you choose know what to do, what you do or do not want done on your behalf? What directions would they follow?

Many people assume that only the sick and elderly need advance directives. But few people are aware that a carefully drafted durable power of attorney for health care is vital for every adult - young or old, healthy or sick, disabled or able-bodied. Consider it if you are young or well as your "if I get hit by a bus" document because the reality is, you may not be pleased about who may be in control of your healthcare decisions if you are unable to speak for yourself and have not made your wishes known in an official way.

"Advance directives are the primary tool for individuals to communicate their wishes if they become incapacitated and are unable to make their own health care decisions, particularly near the end of life. Despite this, 63 percent of American adults have not completed one," reports the most comprehensive study to date on the subject from researchers at the Perelman School of Medicine at the University of Pennsylvania in the July 2017 issue of Health Affairs.

People have fire insurance even though their houses may never burn down. Likewise, competent adults should have a protective advance directive even though they may never be unable to make decisions for themselves.

It can certainly be uncomfortable to contemplate the types of care you might need or might want if you're unable to speak for yourself. But it is even more uncomfortable to contemplate not having your wishes followed and leaving your loved ones with little or no guidance. Many family feuds occur at the bedside when loved ones are at odds with what you would have wanted instead of spending those last moments with you in a more tender and gentle way.

If you are unsure about how you would like to live out your last moments in life, you can make these documents as least or as most restrictive as you would like them to be, and they are not written in stone. You can always revise your advance directives at any given time or as your wishes change. One good way to think about what you would like if you are found in a very physically fragile position is to think of other situations you have witnessed others go through and decide if you would like similar care if you were in that position.

It is therefore critical to have a self-conversation and then subsequently put those thoughts in writing. Thankfully, there are two documents that make capturing these ideas much easier while making sure they are legally valid in North Carolina. Both can be found on the Secretary of State's website.

Health Care Power of Attorney
The first document considers who would make healthcare decisions for you if you could not express your own wishes. This document is known as the Health Care Power of Attorney and is distinct from a durable power of attorney which addresses financial and business matters. This document allows you to appoint someone who can legally speak on your behalf if you are unable to speak for yourself. The document only comes into effect if you are unable to express your own wishes (i.e., if you're unconscious). Until such a circumstance arises, the health care power of attorney does not apply. You can also appoint a second-tier or even a third-tier person in the event that your original healthcare power of attorney could not fulfill their duties.

Living Will
The second critical document is the Living Will. The Living Will describes what you do and what you do not want done and under what circumstances. Think of it as a guidebook to your wishes. It provides direction and guidance as well as informs the decisions of your health care power of attorney.

The good news is that these documents are actually very easy to complete are available at no charge, and do not typically require the assistance of an attorney. It is important, however, that these documents be shared with your family members, your health care decision-makers, and your medical providers. It is equally important that you have candid discussions with your family and loved ones regarding your wishes and regarding who you want to make decisions on your behalf. If you would like to learn more about the importance of advance directives, watch the video that can be found here.

Monday, April 16 is National Healthcare Decisions Day, a day designated to focus on ensuring that all of us have healthcare plans in place. Transitions LifeCare, in partnership with the North Carolina Bar Association and the North Carolina Center for Compassionate Care, is hosting a free community event on Saturday, April 14 to help guide you through the process, get free legal advice about your advance directives, and complete the forms.

Visit transitionslifecare.org/calendar for more details

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