If you’re like most people, then you would want to make the most of the time you have on this earth. If you fall ill with an incurable disease, you may not want to lie in a hospital bed hooked up to beeping monitors and tubes, just waiting to die. Instead, you want to spend your last days in the presence of loved ones in the comfort of your own home.
Louise J. did just that. After a full life helping others as a union leader and peace activist, Louise received a diagnosis of metastatic cancer after chemotherapy failed to stop an aggressive liver tumour. Though some family members begged the 90-year-old matriarch to undergo more chemotherapy, she decided that she didn’t want to deal with any more doctors. Instead, she wanted to take her first trip out of the country to see a little bit of the world she had worked so hard to save.
Fortunately, Louise had both a medical power of attorney and an advance directive in place. The doctors—and her family members—honoured her wishes. Instead of endless rounds of chemo, Louise took her first trip out of the country, accompanied by her daughter. After she returned, the cancer took its toll. Louise, though, remained in control of her health care to the very end. Louise passed away at the home she and her husband had built so many years ago, surrounded by friends and family, at peace with herself and the world.
If you want to maintain in control over your healthcare decisions, you, like Louise, can take charge. You can state your healthcare wishes in an advance directive and appoint a trusted person to carry out those wishes with a medical power of attorney. Make sure that healthcare workers and family members know that you have a plan in place with adequate documentation. Here’s how:
- Appoint a Power of Attorney
- Appoint a medical power of attorney. If you become incapacitated due to illness, you need to make sure that healthcare workers carry out your wishes. Create a legal document, called a medical power of attorney, to appoint a trusted friend or family member to make healthcare decisions for you when you become too ill to decide. Make sure that the person you appoint feels the same way that you do about end-of-life issues to make sure that emotion will not cloud her or his judgement during a critical time. Various states and territories have slightly different laws concerning the medical power of attorney. Consult your state or territory to find out what you need to appoint a person you can trust to take care of this issue.
- Appoint an enduring power of attorney. When you become so ill that you cannot sign papers or pay bills, you may need someone to take care of your financial affairs. You can create an enduring power of attorney document to entrust a loved one to make sure your affairs are in order, your bills are paid, and your assets are secure, even when you cannot do so yourself. This way, you can worry less about financial matters and concentrate on bonding with those around you.
- Create an Anticipatory Direction
Also known as an advance care directive or living will, an anticipatory direction provides detailed instructions that direct healthcare workers to provide only the care you want if you are unconscious or otherwise unable to make your wishes known. Because invasive treatments, such as feeding tubes and artificial ventilation, are often a source of extreme discomfort for people in the last stages of a terminal condition, many people want to request comfort care instead, in which doctors and nurses administer medication and other interventions that make the patient’s comfort, not extending the dying process, their highest priority. An advance care plan does not apply if you have an illness from which you have a reasonable chance at recovery. It only applies when you are in the following two conditions:
- Persistent vegetative state—When a person has not only lost consciousness, but has also lost all ability to react with the world around him or her other than simple reflexes; and the person’s attending physician(s) determine that this state is irreversible, the person is said to be in a persistent vegetative state.
- Terminal condition in its final stages—If a person has developed a condition that makes death a certainty, even with the most advanced life support available, the person is in the final stages of a terminal condition.
- Document Your Wishes
- Have your advance care plan written, witnessed, and signed—Consult the laws of your state or territory for specific requirements in your area. At the very least, you should have the plan written down, witnessed by at least two people, and signed. Even if your state or territory does not require it, you should probably enlist the services of a notary public to witness your signature. The plan should also contain a provision that allows you to revoke or change the plan at any time.
- Make sure your advance care plan is easily accessible—Keep the original of your advance care plan in a safe location that can be accessed quickly in case of emergency. If you have a medical power of attorney, tell him or her where to find the document. If you do not have a medical power of attorney, tell a trusted family member or two where you have stored the document. Because certain situations occur in which a family member or other person cannot arrive soon enough, you may want to consider purchasing a healthcare alert bracelet that indicates your wishes. That way, even if your loved ones cannot locate your advance care plan, your attending physician will know that you want no invasive interventions if you are in a persistent vegetative state or a terminal condition in its final stages.
With all of these precautions in place, you can rest assured that doctors and nurses will honour your wishes for a peaceful end to your life. Having prepared for the end, you can now go forth, as did Louise, and live your life to the fullest.