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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 Directive



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.


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 procedures. They may also include instructions regarding your funeral arrangements and burial.



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.



                                                                                                                                       Holyoke Sun Article for 8/26/98




What Is Middle Age Anyway



Recently my 12 year old daughter asked me if I could remember what it was like when I was young. With raised eyebrows, I asked her exactly when it was that I became old? Well, she said hesitatingly, you’re not old, but you are middle age. What an eye opener. Did I ever consider reaching middle age a goal when I was 12? It wasn’t even a consideration - it just happened.


The amazing reality is that I don’t feel a bit middle aged. The differences between my Baby Boomer generation and that of my parents and grandparents are readily apparent. They expected to reach middle age and then grow older. As I was recently made aware of my middle age status, it made me reflect on those changes that we Baby Boomers are experiencing that are different from previous generations.


The Baby Boomer generation has a different mind set than any previous generation. We are more self-assured, physically active and ready to reinvent ourselves at this phase of our life. According to AARP (American Association of Retired Persons) pollsters, “people between 50 and 59 experience more major life-changing events than in any other decade of life.” The AARP survey reports that:


 10% have lost their mother


 10% their father


 14% saw their youngest child move away from home


 24% became grandparents


 10% have retired from their jobs


 11% were forced to make diet changes because of their health


 16% had gone through menopause, and


 10% became responsible for the care of an aging parent




Generally, people in their 50’s are pretty healthy, even though the 50 year marker has been plagued with negative stigmas. Today, 50-somethings look forward to looking younger and living longer than previous generations.


A cosmetic industry report, The Wrinkle Report, surveyed 1200 baby boomers. “69% of boomers say that having wrinkles doesn’t bother them, but 28% say they would do just about anything short of surgery to look younger.”


The U.S. Census Bureau reports that in 1994, more than 1/3 of all Americans between the ages of 45 and 54 participated in sports - ranging from fishing and cycling to baseball and volleyball. 34.9% bought walking shoes and 33% bought golf clubs.




An awareness of keeping fit at fifty is not unusual. Certain occupations, such as construction workers, police officers and fire fighters, require a physical stamina for any age. For those workers, age can bring a risk of illness and disease. Knowing what risks might affect you and the steps you can take to lower or eliminate your risks can add to your health and longevity.


Another challenge facing the baby boomers is what clinical psychologist, Dr, Hap LeCrone refers to the “Sandwich Dilemma”; as we try to meet the needs of our adolescent and young adult children, while at the same our aging parents are becoming more dependent upon us for assistance due to medical changes. This can be stressful for those who have not anticipated the changes and demands of mid-life. These challenges are not insurmountable though. Here are some guideline to help ease the stress.


Adult children (Baby Boomers born between 1946 and 1964) should allow their parents to continue making their own decisions. Resist the temptation to jump in and take over. This affords the aged parent to opportunity to retain their independence and sense of self-worth. Allow your parents to remain capable adults as long as they are able.


Try not to limit or discourage physical activity such as working around the house or climbing a few stairs. Don’t make invalids of your parents! Creating a dependency or disabling situation can have a profound affect on you life style as well as theirs.


Encourage your parents to socialize and interact with others on a regular basis.


Finally, don’t take your aging parents for granted.


So as you enter the second half of your life, decide that change is possible and don’t overlook the contribution that a healthy psychological perspective plays in successful aging. “Live long and prosper.”







Healthy at Home by Christine Moriarty



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 surrounding communities since 1989.  For more articles that appeared in the Holyoke Sun, "Healthy at Home"  continue to look through our Library of Articles










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