Far too many older adults wake up in ICU or in hospice and remember they meant to do some end of life planning. It would be so much easier to do it while in good health.
Problems Faced When No End of Life Wishes are Known or in Writing
Some older adults may assume their loved ones know them well enough to know their end of life preferences. Yet these ideas don’t come up for discussion very often in everyday life. Even when they are discussed, listeners don’t always tune in to the exact details.
The older patient may not realize the quantum difference between having paperwork completed and leaving things up in the air. For example, if the patient chooses a DNR (Do Not Resuscitate) while in the hospital, or an Out of Hospital DNR (for use in an ambulance of elsewhere like at home) the family or friends who are serving as caregivers can feel comforted that they are honoring the wishes of the loved one who is ill.
But it is not enough to express one’s wishes. It must be put in writing and be available to medical personnel. It can be filled out upon admission to the hospital; it can also hang on the bed of a hospice patient at home.
When no decision has been clarified in writing, the spouse and other loved ones may be left wondering if the patient really would have wanted to live in a vegetative state. Wrestling with this issue can tear a family up at a time when they really need to support each other. Yet without the proper paperwork, a choice will be made by default. But is that the way you want the decision to be handled?
Challenges When Loved Ones Disagree About End of Life Decisions
Some medical decisions revert to the spouse or other family members when no certain person has a Medical Power of Attorney. It is not unusual for several adult children to have vastly differing opinions about what their parents’ end of life decisions should be. Spouses, who often become the caregivers, may benefit from the support of other family members as they often bear the burden of decision making and communication with family and friends.
As a preventive, present your own paperwork and a short explanation either when the family is together or individually to each adult child. This works well when a couple stands united in expressing their wishes. Welcome comments and concerns, yet make it quite clear what you want and expect of them when you are gone. Such discussions may help prevent some of the painful quarrels and resentments among survivors which can cause many years of stress and discomfort among family members.
The terminal patient may think of a way to preserve relationships among siblings and other family and friends by avoiding a standoff during one’s dying days. This can be a time family and friends need to come together to support the patient and each other. You can help make that happen by caring in advance enough to communicate your wishes to all concerned.
Why Some May Need a Medical Power of Attorney
Sometimes older people may not have children. They may have only siblings who could be frail or in ill health themselves. At times the spouse is unable to serve in this capacity due to ill health. This may lead to the need for a friend taking on the task of medical POA. This person would assist in medical decisions and become the patient’s advocate and communicator. The person with this medical power of attorney may need to coordinate professional or volunteer caregiving, home health and other appointments.
Making end of life decisions, possibly including DNR and medical power of attorney, can keep you from wasting away without support when it is most needed. The time to act is now, before medical issues become more serious. Schedule time to discuss with your spouse and other family members as well as dear friends to allow loved ones time to accept your choices even if they disagree. This can prevent added suffering on their part and allow them to support one another when such times come rather than argue or take out their grief on each other. So do your paperwork as a gift to those who stay behind.