Studies have shown that 90 percent of Americans have specific wishes for their end of life care, but only 30 percent of them talk with their families or write it down in an Advance Directive.
That sometimes leaves family members guessing what their loved one wants and agonizing over crucial decisions that cannot be delayed. These situations place a tremendous emotional burden on the family members trying to make those decisions.
Floyd encourages everyone over 18 to think about an Advance Directive — you never know when you might need it. The good news is it is free, good anywhere in the state and, because of reciprocal state agreements, good in almost anywhere in the United States.
What exactly is an Advance Directive? It is a legal document that explains who you want making your medical decisions if you cannot make the decisions yourself and also provides guidance for that decision-maker regarding which aggressive interventions you want and do not want.
Approximately 10 years ago, the state of Georgia merged the Medical Power of Attorney document and the Living Will document. The new document is called an Advance Directive, although many people are still more familiar with the prior terminology.
An Advance Directive lets your health care team and loved ones know what kind of health care treatments you want and who you want to make decisions for you when you can’t. Even the process of considering an Advance Directive can be helpful.
Going through the process can help you think ahead of time about what kind of care you want. It may help guide your loved ones and health care team in making clear decisions about your health care when you can’t do it yourself.
There are basically four main elements in the creation of an Advance Directive:
Establishing a health care agent — This is the person who will be making medical decisions, and ONLY medical decisions, on your behalf. The Advance Directive does not give them control over your finances or other issues.
Treatment preferences — What treatments would you want or not want if you were in a permanent state of unconsciousness or the very end of a terminal condition? Would you want CPR or to be placed on a ventilator or have a feeding tube surgically implanted? Discussing such issues while you are still healthy may give you peace of mind and make it easier on your loved ones to make decisions.
Guardianship — This names your preference for a guardian if one was ever needed. That must be approved by a judge.
Signatures — An advance directive requires the signatures of 2 witnesses who are not family and not part of your medical team. That avoids any possible conflict of interest.
While this might seem complicated, consider what happens if you require medical care and cannot represent yourself. State law dictates who will make your medical decisions and the care you receive until that decision-maker is identified and located.
The state dictates that your next-of-kin is your decision-maker and provides a detailed ordering to identify the next-of-kin, starting with spouse, then grown children (equally), then parents (if living), then siblings (equally).
Consider the following scenarios:
A patient with no spouse shared that he had three grown children but that he didn’t trust any of them. He named a niece that he did trust to be his health care agent.
A patient with no spouse who could not communicate. The patient had nine children, who were legally equal decision-makers. This made it difficult to reach consensus and make needed decisions.
One gentleman did not want to place the emotional burden of hard medical decisions on his wife and named his pastor, with whom he had discussed his wishes.
We regularly encounter couples who have been together decades but are not legally married. The boyfriend or girlfriend has no legal standing and we are required by law to seek out other family members if the patient declines and can no longer represent themselves.
Just a few years ago, my mother was diagnosed with advanced cancer. She had an Advance Directive and we had talked about her wishes several times.
These were hard conversations, but I am glad we had them. While it was not easy, as her health care agent I knew I was following her wishes every step of that journey. This gave us both peace of mind and helped us enjoy the time we had left together. Her Advance Directive was a gift that I did not fully appreciate in the moment.
Planning for your future health care needs might not be pleasant to think about, but that process might give both you and your loved one’s peace of mind. At Floyd we are trained to help you through it. For more information visit www.floyd.org or call the chaplain’s office at Floyd at 706-509-5199.