Posts Tagged ‘Advance directive’

Good Read for the Sandwich Generation

Posted on: May 5th, 2017 by Jamie

Good ReadAttention Sandwich Generation Members: If you need something to read while relaxing on this upcoming soggy spring Saturday and Sunday, I highly recommend Can’t We Talk About Something More Pleasant?  by Roz Chast It’s not new, it came out in 2014 and won lots of awards, but I finally got around to reading it. This memoir details the author’s journey with her parents aging, decline, moving and ultimately their passing.

The graphic novel style makes it an easy read. It is heartbreaking, funny, unflinchingly authentic, and relatable – if you are going or have gone through this with your own parents.

If you haven’t had conversations with your parents about the future, make it happen as real life won’t wait for you to do so. Planning is power – Good luck!

Good Read

The Cycles of Life Part 6

Posted on: August 26th, 2016 by Jamie

The Cycles of Life 6For some people, the financial planning piece is the hardest part. For others, the health care piece is more difficult. You probably have a good idea about how your loved one feels. Either way the health care planning is equally as important, especially if there is a chronic illness present. Again, be gentle, yet firm; be empathetic yet realistic; be compassionate yet solution oriented. Be kind and be patient, this is hard. Communication continues to be the key/foundation to knowledge and knowledge is power.

If you have been following the previous posts, you already have created the foundation for the “official” health care planning paperwork. All of those ongoing conversations with your loved ones about their health and future goals should hopefully make this a bit easier. Now it is time to convert those conversations to paper on an Advance Directive for Health Care. It may be called something different where you live. Documents and laws vary state to state and typically a lawyer is not needed to complete it.
Another document to fill out is a DNR (Do Not Resuscitate)/COLST or POLST (Clinician or Physician’s Orders for Life Sustaining Treatment) Order. This is the Vermont DNR/COLST with instructions. Here is a comprehensive tip sheet from the Family Caregiver Alliance website regarding these documents.


I find the Vermont Ethics Network booklet entitled Taking Steps: Planning for Critical Health Care Decisions very helpful as it provides thorough explanations and instructions plus worksheets to help gather thoughts and feelings. Their website also has several forms you can download. They provide an overview of the basics for health care decisions and advance directives here.


Ultimately these discussions are truly about end-of-life issues. If you need additional resources to help you and your loved ones you may want to check out The Conversation Project:

“The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care.
Too many people are dying in a way they wouldn’t choose, and too many of their loved ones are left feeling bereaved, guilty, and uncertain.
It’s time to transform our culture so we shift from not talking about dying to talking about it. It’s time to share the way we want to live at the end of our lives. And it’s time to communicate about the kind of care we want and don’t want for ourselves. 

We believe that the place for this to begin is at the kitchen table—not in the intensive care unit—with the people we love, before it’s too late.

Together we can make these difficult conversations easier. We can make sure that our own wishes and those of our loved ones are expressed and respected. If you’re ready to join us, we ask you: Have you had the conversation?”

In Vermont, we have a great resource that partners with the Vermont Ethics Network called Start the Conversation. For New Hampshire, they are here. These organizations offer downloadable conversation starter kits plus videos and lots of tips and good information. The Conversation Project also has a new resource for families and loved ones of people with Alzheimer’s and other forms of dementias.

No doubt these are difficult conversations to have BUT it is imperative you have them and continue having them as needed because things change. Once these documents are finished everyone will have peace of mind from knowing legal matters and medical preferences are spelled out. You won’t have to make a decision in crises-mode because you have been empowered to make an informed decision based on your loved ones wishes and goals.
After seeing your aging loved ones completing these legal and health care planning documents, you and your spouse need to do them as well. You now know just how critical they are. Update them as you yourself age and begin to have discussions with your children (if appropriate, of course) about your wishes and goals. As Start the Conversation wisely says, 

“Planning for end-of-life care before it becomes a worry is as important as all the other life plans you have made. Having a plan in place in advance makes it easier for you, your doctor and your loved ones if you are unable to tell them your health care choices because of an injury or serious illness.
Every moment is precious-especially at the end-of-life. Starting the conversation early can ensure that your choices are heard. It also means that when time becomes short, it can be spent doing what you enjoy most and not making last minute decisions. Talk about your wishes while you are in good health so you will be prepared. A health crises can happen to anyone at any time. Don’t wait. Start the conversation today. It’s a gift.”

Advance Care Directives

Posted on: March 3rd, 2014 by Armistead Admin

You may not be able to make health care choices for yourself if you are very ill or injured. An advance care directive is a legal form. It tells your doctor in advance what care you agree to.

Why Write an Advance Directive?

When you are unable to speak for yourself due to an illness, your health care providers may be unclear as to what type of care you would like.

Your family members may be uncertain or disagree about the type of medical care you should receive.

Using an advance directive, you can tell your doctor what medical treatment you do not want to have. You can also state what treatment you want no matter how ill you are.

Writing an advance care directive may be hard. You need to:

  • Know and understand your treatment options
  • Decide future treatment options you may want
  • Discuss your choices with your family

Studies show that most people believe having an advance directive is a good idea; yet, most people have not created one for themselves.

Living Wills

A living will explains the care you do or do not want. In it, you can state your wishes about receiving:

  • CPR (if your breathing stops or your heart stops beating)
  • Feedings through a tube into a vein (IV) or into your stomach
  • Extended care on a breathing machine
  • Tests, medicines, or surgeries
  • Blood transfusions

Each state has laws about living wills. You can find out about the law in your state from your doctor, the state law organization, and most hospitals.

Other important facts include:

  • A living will is not the same as a last will and testament after a person’s death.
  • You are not able to name someone to make health care decisions for you in a living will.

Other Types of Advance Directives

Special health care power of attorney is a legal document that allows you to name someone else (a health care agent or proxy) to make health care decisions for you when you cannot.

NOTE: It does not give power to anyone to make legal or financial decisions for you.

DNR (do not resuscitate) order.This tells health care providers not to do CPR if your breathing stops or your heart stops beating. Your doctor talks to you, the proxy, or family about this choice. The doctor writes the order on your medical chart.

Fill out an organ donation card and carry it in your wallet. Keep a second card with your important papers. You can find out about organ donation from your doctor. You can also have this choice listed on your driver’s license.

Verbal instructions. These are your choices aboutcare that you tell health care providers or family members. Verbal wishes usually replace those you made previously in writing.

What Else?

Write your living will or health care power of attorney according to your state’s laws.

  • Give copies to your family members, health care providers, and health care agent
  • Carry a copy with you in a wallet or glove compartment of your car.
  • Take a copy with you if you are in a hospital. Tell all medical staff involved in your care about the documents.

You can change your decisions at any time. Be sure to tell everyone involved — family, proxies, and health care providers — if a living will is changed. Copy, save, and share the new instructions with them.

Alternate Names

Living will; Power of attorney; DNR – Do not resuscitate; advance directive


Kapp MB. Ethical and legal issues. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia,Pa: Saunders Elsevier; 2007:chap 6.

Update Date: 4/7/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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