November 27, 2019
The Gift of Peace of Mind
This holiday season, the gift of peace of mind is one of the most important gifts you can give to – and receive from – your loved one. One way you can do this is by opening a conversation with your loved one about his or her healthcare preferences, should you or your family need to someday speak and act on your loved one’s behalf.
Not only will planning ahead help alleviate stress and decision-making burdens on the entire family, it will help your loved one regain a sense of control and empowerment. Starting the conversation about one’s end-of-life care can be a positive, life-affirming experience. It’s about sharing thoughts, hopes and dreams, and it helps ensure peace of mind for the individual and his or her family.
Talk about the Tough Questions
Decisions about end-of-life medical treatments are personal and should be based on one’s values and beliefs. When you talk to your loved one, ask the following questions:
- We all have different ideas on what our last day on earth would look like. What would you like your last day to be like? What would you be doing? Would you want special music played, spiritual passages read to you, letters shared with your loved ones?
- Where do you want to be at the end of life? Would you prefer to be in a hospital, a nursing home, a hospice house, or your own home?Some people may feel being at home creates too great a burden for their family; for others, being in the comfort of their own home gives them peace of mind.
- Who do you want with you when you die? To some, being surrounded by family and friends is important; to others, having one or two loved ones or a spiritual care counselor nearby is what they envision.
It is impossible to foresee every type of circumstance that might occur. What is important is that you understand what “quality of life” means to your loved one. Additional questions to ask include:
- How do you feel about pain management? Would you want as much as necessary, even if it meant making you unconscious? Or, is maintaining alertness, even if it means being in some pain, more important to you?
- If you could no longer swallow, would you want artificial feeding tubes used?
Once you’ve had a conversation with your loved one about his or her healthcare preferences, it’s time to put those wishes in writing. Advance directives are legal documents that allow someone to give directions for medical care, should the individual become unable to speak or communicate his or her desires. Advance directives can be used to request or refuse treatment and to express feelings about other healthcare issues. Advance directives ease the burden on family members, who can then more confidently carry out their loved one’s wishes.
Advance directives usually take effect only if the individual has a terminal condition and is unable to make decisions. Those who are lucid and able may make their own healthcare decisions, even if they contradict their advance directives. The documents can be changed or revoked at any time. There are two major types of advance directives: living wills and durable power of attorney for healthcare. Both forms are free and downloadable from EveryStep’s website.
- Living will, also known as a “medical directive” or “declaration relating to use of life-sustaining procedures,” provides written instructions to one’s physician. It explains the person’s wishes for healthcare in the event he or she can’t communicate as a result of a terminal condition or irreversible coma. Often these documents say whether the individual wants life-sustaining procedures to be withheld or withdrawn under certain circumstances or in certain situations.
- Durable power of attorney for healthcare, also known as “heathcare proxy” or “appointment of a healthcare agent,” lets an individual name a person to make medical decisions on his or her behalf if he or she becomes unable to do so. The durable power of attorney for healthcare is required to follow directions provided in the advance directive. The person named in a durable power of attorney for healthcare should be:
- someone the individual trusts
- someone who has consented to act as the agent
- someone over the age of 18
- someone who is not a member of the individual’s healthcare team (not the individual’s doctor, nurse or employee of the facility providing care), unless the individual is a close relative
Complete Advance Directive Forms
In Iowa, a lawyer is not required to complete an advance directive. However, to be legal, the signature on an advance directive must be:
- witnessed by two people not related to the individual or providing his or her care; or
- witnessed and notarized by a notary seal.
Finally, it’s important that other people are informed of your loved one’s wishes. Advance directives have no power if no one knows they exist.
- Encourage your loved one to give copies to other family members and his or her doctor.
- Keep the originals in a safe but accessible place.