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Holyoke Sun Article for 8/26/98
Healthy at Home
by
Christine Moriarty
Advance Directives
When we are healthy and living an active and productive life, most of us give precious little thought to whether or not our legal and medical rights may be in jeopardy. Many of us don’t even think of these issues until a medical emergency arises and we find ourselves faced with the very real possibility of a drastically changed lifestyle.
Will you still have choices regarding your medical care? Will someone you trust carry out your wishes, or will these decisions be made by a stranger? Don’t wait until you are lying in a hospital bed thinking, "I should have…". Advance Directives for your own health care should be in place before you find yourself in this situation.
Trying to sort out the alternatives for your personal health care should begin with a consultation with your physician or health care practitioner and then be discussed with your family and close friends. In addition to the medical information regarding your condition, prognoses, options for treatment, and possible outcomes; your personal and religious beliefs regarding life sustaining or prolonging methods will affect the ultimate decision.
- Are you in favor of organ donation?
- Do you want only comfort measures if the medical prognosis is poor or life expectancy is limited?
- What kinds of comfort measures do you desire and how do you want them administered? (i.e. oxygen therapy to ease breathing, a gastric tube for feeding, a do not resuscitate policy under certain conditions, medication to alleviate pain and discomfort)
- Are your doctor and/or your medical proxy aware of your desires?
Many of you have heard of a Medical Health Proxy, Living Will, Durable Power of Attorney or Advance Directive, but are not really clear about the differences and how each one can affect health care decisions.
Advance Directives is a general term that refers to legal documents that delegate our health care decisions to someone else when we are incapable of making those decisions for ourselves. The term refers to directives that are drawn up before the onset of a medical need to be prepared for the future.
The Living Will and the Durable Power of Attorney for Health Care are advance directives that can name a person to make decisions and spell out specific instructions regarding your desires regarding medical treatments and procedures. They may also include instructions regarding your funeral arrangements and burial.
The Health Care Proxy is a specific type of advance directive that is recognized and widely used in the Commonwealth of Massachusetts.
Here is some common medical terminology regarding life-sustaining treatment that is often found in advance directives.
CPR or Cardiopulmonary Resuscitation – a procedure that is used to revive a person who is in cardiac or respiratory arrest.
DNR or Do Not Resuscitate Order (sometime referred to as No Code) – a statement signed by the patient (or medical proxy) declaring that no attempt to resuscitate will occur or be performed in the event that a cardiac or respiratory event occurs.
Irreversibly or Terminally ill – used to describe a near death state with no chance of a cure.
Life Sustaining Treatment – any treatment that is given to a patient who is near death to postpone death.
Supportive Care – comfort measures that are given to a person who is near death and has no hope of recovery to ease their dying.
With an Advance Directive in place, you can be assured that your health care decisions will be made according to your wishes even if you are no longer able to make them for yourself; and eliminate the need for the courts to appoint a conservator to oversee your care.
Your desires regarding your health, your body, and your medical care should be recorded in advance. It will give you real peace of mind and alleviate the stress that making those decisions can place on your family and friends.
Christine Moriarty is Director of Nurses for Commonwealth Registry of Nurses in Easthampton, a full-service home health care agency that has served Hampshire County and the surrounding communities since 1989.
