Docs & THE CONVERSATION

Docs as in document document document!  

The Conversation has no power without related documentation.  Knowing a relative or loved one or best buddy feels a certain way about end-of-life issues means zip if it's not properly written down.  

Personally, I never had to start The Conversation - Mom did.  Her attention was engaged on living wills from the moment she first heard them mentioned on NPR.  

Small wonder.  Mom was all too familiar with medical crises - she & Dad were in California when he collapsed getting onto their flight home, when he was diagnosed with brain cancer, when they had a variety of decisions to make regarding his diagnostic care & treatments.  And she was incredibly grateful that Dad was alert & able to participate in all the decisions regarding his care - she was surrounded by people facing similar crises, whose beloved couldn't let them know what he or she wanted.  

As soon as she heard about living wills, Mom requested one, filled it out, had Mim & me witness it.  

Through the years, the family - with Mom as fearless leader & inspiration - learned all about her views on what she considered reasonable treatment & where she drew the line.  

We also learned that a living will is just one of many advance directives that clarify a person's hopes  & desires concerning testing, treatments & care, in case the person is unable to be make their own medical decisions.

What is a "living will"? 

A living will is a WRITTEN, legal document that outlines which types of testing, treatment & care you would want, which ones you do not.  They are spelled out, avoiding vague wording & fuzzy language, against the day you might not be able to make those wishes known.  Mom's specified that she didn't want extraordinary measures  - mechanical breathing, feeding tubes, non-surgical resuscitation - taken to revive her. 

A good first step is to do an online search of  "advance directives" and your state.  Voila!  Lots of good, sound advice out there.  

When Mom took her tumble in Virginia, I was on the computer as quick as I could, checking out if Virginia's advance directives were significantly different from Pennsylvania.   Whew - it was just fine.  But that might not have been the case.  It might not have been accepted in New York, where being Mom's health care agent might have disqualified me as a witness.

Through the years - and especially after Mom's final hospitalizations in Virginia & back in Pennsylvania - I became an expert on the ins & outs & 'round abouts of living wills.  What I've learned includes:

• A health care proxy should be named at the same time a living will is executed.  I took over as Mom's health care proxy after Mim moved out of state, so it wasn't an issue.  The American Bar Association advises to always have both.  (more about health care proxies later)
• Keep a copy of your living will in your wallet.
• Make sure at least one family member has a copy.
• Be sure your family members know what's in the living will.  (Although their wishes can't override the written, witnessed document, their cooperation can make things go a lot easier.)
• Be sure you or your health care proxy confirms that the hospital will fully honor any request to abstain from "heroic measures" you specifically decline. 
• Here's one that surprised me - be sure to have LOTS of copies of any advance directive, including the living will, and make sure that if the patient changes units, each unit gets a copy.  At St. Mary's, where Mom had multiple moves between & back to regular care & ICU, the directives were not transferred with her - it was my responsibility to make sure each unit had it & were aware of her wishes. 
• Age isn't a factor in writing out a living will & naming a health care proxy.  Dad was younger than I am when he died soon after his diagnosis.  Accidents happen & illness strikes even the very young.  

My life was so much simpler, thanks to the many conversations Mom & I had ~ and ~ to the Mayo Clinic's website's excellent overview of advance directives.

My siblings & I knew what Mom wanted done for her medical care.  She designated a health care proxy & she kept her living will with her at all times.  She made sure that I knew where it was filed.  

Have The Conversation with your loved ones.  In addition to your family members, make sure that at least your pastor, at least one friend knows your wishes in the event you can't speak up for yourself.  Record your wishes in a living will, have it witnessed & make sure it's easy to find & access.  Document document document!