Living Wills.........Am I Too Young?
The quick and simple answer to the question of the hub is no. No one is guaranteed to live into their elderly years; therefore the responsible thing to do is to let loved ones know what to do should you become incapacitated. We hear of so many stories of how an accident occurs leaving a person in a vegetative state; the family then fights over “pulling the plug” versus leaving the person on life support while hoping for a miracle. No one is wrong in any of these instances, but so much time, heartache, grief, guilt and money could be saved by creating a simple document.
A living will is a document stating a persons wishes regarding medical measures to be taken should he or she no longer be able to speak for him or herself. This is often confused with a last will which outlines how belongings are to be distributed; they are not at all related. What is included in a living will is described in the picture below “Contents of a Living Will: Treatment Options”.
Lets discuss some specific options for living wills. Palliative care, which is a service that keeps a person comfortable by alleviating or lessening pain, is a common choice for end of life care. This may include medications to prevent or relieve pain, anxiety/restlessness, and suffering of any kind. It may also include the administration of oxygen and several other comfort measures. Many people choose not to have heroic measures taken such as Cardiopulmonary Resuscitation (CPR), life support, or life sustaining medications. CPR is an intervention initiated when a person is pulseless or stops breathing; it creates blood flow by pumping the heart so that vital organs do not die and provides artificial ventilation. The compressions made to pump the heart can be very traumatic and damaging to those who are very frail so is often CPR is not chosen in living wills.
When no CPR is chosen, the person is listed as a Do Not Resuscitate (DNR); which means once the heart stops beating or breathing ceases no further action is to be taken (a natural death). In Ohio, DNR orders are expanded to include Comfort Care (DNRCC). Comfort care is similar to palliative care which was described above. There are two types of DNRCC’s in Ohio; DNRCC and DNRCC-A. DNRCC is the same as DNR except patients may be given medications to relieve pain and anxiety and other measures to provide comfort but not any life saving measures. According to the Cleveland Clinic (2010), “DNRCC-A orders permit the use of life-saving measures (such as powerful heart or blood pressure medications) before a person’s heart or breathing stops. However, only comfort care may be provided after a person’s heart or breathing stops”.
Creating a living will is fairly simple; template forms are available in every state (forms vary state by state). When making a living will, it is advisable to speak with your doctor regarding your options. After deciding what your final choices will be, the form will need to be signed by you and two other adult witnesses before a notary public. Once completed, it is important to note that you will need to have this document (or a copy) in hand if you are hospitalized so that they have your wishes on file. At any time, you may change your mind about your end of life care options.
In addition to a living will, having a Durable Power of Attorney (DPOA) is fairly common. A DPOA is a person appointed by you to handle your healthcare and financial matters if you become unable to make decisions or speak for yourself. It is often advised that a DPOA be drafted up with the assistance of an attorney due to the DPOA’s access to finances and his/her ability to make decisions once the patient is incapacitated. You may choose to have DPOA for only medical or only financial or both. A DPOA may also require notarization depending on the state you live in and should also be in hand and presented to health care staff in cases of hospitalization. In Ohio the living will and DPOA together are called Advance Directives.
Durable Powers of Attorney and Advance Directives
Durable Power of Attorney
Life Planning Quiz
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Making the decision to put your final wishes and the deciding on who will handle your affairs should you become unconscious or unable to make decisions can alleviate some of the stress that your loved one will have to go through. It is a responsible decision to make at whatever age you are because you never know what may happen tomorrow. Having discussions with your doctors, family members and other loved ones about your wishes in addition to creating the living will and DPOA documents is also necessary to avoid confusion during a high stress period that comes along with traumatic events and even with chronic illness. Being proactive in life planning is the responsible and considerate thing to do for those who love you.
Cleveland Clinic. (2010). “Do Not Resuscitate” (DNR) Orders and Comfort Care
Senior Living Blog. (2015). Ways to Create a Living Will.