I want to expand a bit on my last column about end-of-life decision making and Durable Power of Attorney for Health Care. A Durable Power of Attorney for Health Care is an essential tool for all of us. It allows each of us to define our quality of life to the end. Not having this documentation often leads to dissension and a struggle among your family and loved ones.
Let’s look at a worst-possible scenario:
Imagine that you do not have a Durable Power of Attorney for Health Care. You are in a car accident that requires hospitalization in the ICU. You are nonresponsive and you cannot participate in decisions about your treatment choices.
Your three children gather at your bedside and your son asks the physician, “How long will you keep mom on that ventilator?” The doctor responds, “Her condition is very serious. Let’s wait and see how the next few days go.”
After the doctor departs, your youngest daughter says, “Mom said she never wanted to be kept alive on machines, why do we have to wait a few days? Mom would be furious that we are keeping her alive.” And her older sister adds, “I don’t remember her saying that … it’s so depressing to think of unplugging her. How can we do that? We have to give her a chance to recover.” And your son retorts, “Stop bickering, you two. I’ll decide when and if we pull the plug.”
You get the point.
This scene is not unusual. Families tend to disagree, especially under stress. In the meantime, you could be the one being kept alive against your wishes and preferring that big medical bills don’t pile up when there is little hope of a meaningful recovery. There is a higher road here. Have the conversation before the crisis.
Talk to your children about your wishes in the event of a dreadful, unexpected life-and-death emergency. While most couples talk to one another about these kinds of issues, most parents are reluctant to talk to their children.
It is a difficult conversation to initiate, it is a loving conversation to experience. Having the conversation is a gift of guidance to clarify what you would want done; a gift of trust to empower someone to speak for you; a gift of well being to comfort those you love. And ultimately, this gift is your legacy to describe your values and beliefs.
You will know the best time and place to do this. Whether it is Thanksgiving when everyone is home or a family vacation when everyone is mellow. Perhaps it is after your spouse dies or before a long trip. Whatever time you choose will be perfect. If your spouse is still alive, together explain to your adult children who and why you select to be your “agent.” (Your agent is someone you trust, who can stand up for your wishes, and who communicates well with physicians and the rest of the family.) It’s also a good idea to name an alternate, in case your first choice isn’t available.
Communicating with your family and loved ones is important. Getting your wishes down in writing is crucial. You and your loved ones will be glad you did … and do it now!
Click here to download the California Medical Association’s Advance Health Care Directive Kit or call 805.563-8820 to request that the forms be mailed to you.
— Gail Rink, MSW, is executive director of Hospice of Santa Barbara.