Revisit advance health directives every five years, attorney says
According to discussion at last week’s senior center program, advance health directives are essential when considering how you’d like your final days to be and they offer assurance that your medical care is carried out as you’d like at a time when you may not be able to instruct caregivers or doctors.
In a culture where death isn’t readily discussed, you can have peace of mind that your wishes concerning how you die are carried out through an advance health directive, according to speakers at a series on end-of-life decisions at the Pickens Senior Citizens Center on Stegall Drive.
The Georgia directive, which can be found online, combines a living will and a durable power of attorney for health care, allowing people to choose for themselves issues relating to their medical care. From assigning a health care agent and guardian to detailing treatment preferences such as whether you want to withhold or withdraw life support or accept or refuse nutrition and/or hydration, the health care directive can be an all encompassing tool to ensure you control all aspects of your personal and medical care.
Along with the directive, Margaret Ognen with Affinis Hospice who is coordinating the four-week program at the senior center, said it’s also important to share your wishes with others who can be your voice.
“There’s a space on the directive where you can appoint three people as your decision maker if you can’t do it,” Ognen said. “It can be a family member, a friend, a physician – anyone you think can be your voice, your advocate if you can’t do it. It’s going to be a big decision but you’re at peace with it and they’re on board with it. You always want to have three people who know your wishes. My big hope since I started with hospice is getting everyone to recognize that they need to start planning. Hospice doesn’t need to be end of life. Hospice can give hope to those faced with a decision.”
Jennifer Galligan, a local attorney who handles estate planning and litigation, spoke to the group last week and advised everyone to review their health directives every five years and pointed out that living wills and life support directives are different from DNRs (Do Not Resuscitate Orders).
“If your heart stops a DNR tells them not to resuscitate you but health care directives addresses life support issues and all that. It’s a lot more comprehensive and even includes (information regarding) autopsies and whether you’d like to be cremated or buried. You can get the document off the Internet but I would recommend having an attorney discuss it with you. We can help people get a full idea of what they’re signing,” Galligan said.
Along with Galligan, Ognen asked Dr. Michael Harris to speak during the program. Harris is elder care specialist who worked at Piedmont Mountainside Hospital for three years as a hospitalist and now has his own internal medicine practice at First Mountain Medical.
“A DNR does not make decisions about life support,” Dr. Harris said. “A living will says if you have no hope from a terminal illness that medical care will withhold “heroic action” medically. Usually a living will comes into play if you are unconscious or unable to make that decision.”
Harris said hospitals have case managers who get information regarding advance directives, living wills and DNRs when patients are first admitted.
“When you open a patient’s chart at the hospital that’s the first thing you see,” Harris said.
Responding to questions from seniors attending the discussion regarding whether doctors listen to their patients’ wishes or their family members, Harris said he always listens to the patient.
“I take whatever the patient’s wishes are right then and there, even if it’s different from a loved one who’s right there. If the patient is competent and they can tell me what they want I have to take their wishes. If they’re not competent, and without a directive, then I go to the family.”
Dr. Harris’ wife, Tracy, an RN and former hospital case manager, said hospitals also have ethics committees that might come into play when such issues arise.
Advocating in favor of advance directives Harris said, “We have the medical availability to make that miserable experience go on and on and sometimes that’s not what you want to go through.”
Depending on your medical condition there are many things that you can do to support life, Harris said, but it may not be what the patient wants. Advance directives make it clear.
Public welcome at upcoming sessions
on end of life decisions
Next Wednesday, March 30, a guest speaker is lined up to talk about their choice to give up cancer treatment in favor of hospice and palliative care. Palliative care is specialized care focused on the pain, symptoms, and stress of serious illness. The program will start at 9:30 at the Pickens Senior Center on Stegall Drive.
On Wednesday morning, April 6, Ognen will present part three of the four-part film documentary on dying by Bill Moyers, On Our Own Terms. The series focuses on end-of-life tools, care options, final days and therapy and support.
April 13 Ognen will have a guest speaker on spiritual care and on April 20 the program will wrap-up with final questions and answers focusing on community options and advice.
The senior center is located on Stegall Drive, near the entrance to Lee Newton Park.