It happens all too often: families come to see me, distressed, because they don’t know what to do when their loved one has suffered a serious illness or becomes incapacitated. They don’t know what type of medical interventions their loved one would want, how they feel about artificial nutrition, like a feeding tube, or if they should just try and keep them comfortable. It adds tremendous pressure on an already difficult situation.
That’s why I counsel all my patients to set up an advance directive. An advanced directive lets families and doctors know what type of medical treatment a person would want when they are no longer able to speak for themselves.
Miami Jewish Health Systems recently conducted a Harris Poll and found that nearly three out of five adult Americans surveyed – 59% − said their loved ones do not have an advanced directive in place, or are not sure if they do.
Although this is alarming, I am not surprised by the results. This is a topic that rarely gets spoken about. There’s a feeling, “Oh, they’ll know what to do in this situation.” But without an advanced directive, family members don’t always know what to do.
I often refer patients to Aging with Dignity, a non-profit organization that has a simple living will on its website that meets the legal requirements for an advance directive. It’s called Five Wishes and lets family and doctors know the following:
- Who you want to make health care decisions for you when you can’t make them.
- The kind of medical treatment you want or don't want.
- How comfortable you want to be.
- How you want people to treat you.
- What you want your loved ones to know.
I also like to remind patients that an advance directive can be modified at any time and it doesn’t have to be all or nothing. A time-limited trial of care to allow for certain interventions or therapies a chance to work is highly recommended. And just as important as it is to put advanced directives in writing, the person you choose as a surrogate is also very important. Someone too close to you may not be the best choice because they may not be able to carry through on the decisions you want.
Seniority Matters note: Guest Blogger Brian J Kiedrowski is the Senior Vice President and Chief Medical Officer at Miami Jewish Health System, a large healthcare providers for seniors in South Florida.
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