PUBLISHED: 5:21 PM on Wednesday, September 3, 2008
Plan your healthcare wishes ahead of time
15 years ago this month I sat in a hospital room comforting my husband who had received a bone marrow transplant for Leukemia. I was 27 years old.

A that age, I was not thinking about what I wanted if I were seriously injured or facing a terminal illness. After all, we are invincible at that age, aren't we?

  photo courtesy of Bartlett Regional Hospital It's never to early to think about identifying wishes for end-of-life care.
What got me thinking about what I wanted if I were too ill to make decisions for myself was watching other families agonize over decisions about what to do when their loved one was no longer able to express their desires for care.

Of the six patients on our unit who received transplants at approximately the same time, three died during our extended stay. I remember crying with other family members for their loss while being thankful that my husband was still alive - however limited that life was at the time.

The most traumatic experience I had during that time was witnessing the pain and anguish of a family who had not discussed or agreed upon what would happen if and when faced with end-of-life decisions. I learned that patients and loved ones alike suffer when the latter are left to guess at the patient's wishes regarding significant medical treatment decisions.

I watched as loved ones were left to agonize over what treatments to start or continue, and all too often in their reluctance to let go there were interventions made that may have added burden to the dying process. Watching families torn apart by the experience was heart wrenching; parents, children, in-laws, and siblings arguing over what was best for their loved one.

This experience got us talking about what we wanted in the event that we were not able to speak for ourselves. We didn't stop with talking either. We wrote it down and shared it with our families. One thing was sure: I didn't want my loved ones arguing over what they thought I wanted. I wanted them to know.

We learned together that the time of crisis is not the time to be discussing what we wanted, but at least it wasn't too late.

Facing the possibility of incapacity

Incapacity means that you are either mentally or physically unable to take care of yourself or your day-to-day affairs. Incapacity can result from serious physical injury, mental or physical illness, mental retardation, advancing age, and alcohol or drug abuse.

Wherever you are, whatever the situation, you want to be sure that you receive appropriate treatment. Even more importantly, you want your decisions to be honored.

Getting your paperwork in order

An advanced directive is a document that communicates your wishes about health care treatment at a time when you cannot speak for yourself. You do not need a lawyer to create an advanced directive.

There are two components to an advanced directive: A living will is a written document that identifies your wishes for end-of-life care. It allows others to know your wishes about medical care in the event that you are terminally ill or in a persistent vegetative state and can no longer make your own medical decisions. A durable power of attorney for health care allows you to name someone, usually a family member or close friend, to make decisions about your medical care if at any time you are no longer able to speak for yourself. You are also able to name other people to act as alternate agents in this regard should your designee be unwilling, unable or is not reasonably available to make a health care decision for you.

Every time you visit Bartlett Regional Hospital, you will be asked if you have an advanced directive/living will. This isn't done to frighten or annoy you. It is hospital policy in accordance with state and federal law, to respect a competent adult patient's right to make his or her own health care decisions. If you do not have advance directive or a durable power of attorney for health care you will be given information regarding these. The hospital has forms available for you to complete should you choose to do so.

Beverly Jones, Patient Access Supervisor, encourages individuals to seriously look at the information and understand what it is about. The decision to complete the paperwork is extremely personal. It should be about what you want in the event that you are not able to speak for yourself. These documents should be accessible by you or your designee.

Incapacity can strike anyone at anytime. Even with today's medical miracles, it's a real possibility that you or your loved one could become incapable of handling your own medical affairs. A serious illness or accident can happen suddenly at any age. Designating one or more individuals to act on your behalf can help ensure that your wishes are carried out if you become incapacitated. Otherwise, a relative or friend must ask the court to appoint a guardian for you, a public procedure that can be emotionally draining, time consuming, and expensive.

Ensure that your advance directive is available when you need it, wherever you are. Bartlett has partnered with the U.S. Living Will Registry®, a nationwide service that stores your advance directive electronically and makes it available 24 hours a day to health care providers across the country. This eliminates worries about carrying your advance directive with you, as well as problems of finding it should you become ill.