REPOSTED from WCEXAMINER.COM by C.J. MARSHALL / PUBLISHED: AUGUST 3, 2016
If you became incapacitated, who would insure that your desires concerning your care be carried out?
Who would determine what medical care you would – or would not -receive, depending upon your wishes?
Who would oversee your finances, your wishes concerning how you are treated during the final stages of your life, and instructions about what should be done once you pass from this world?
These and other important questions concerning Advance Care Planning were addressed by Dr. Edward Zurad of Tunkhannock, a specialist in geriatric medicine, who spoke at the Tunkhannock Active Adult Center on Wednesday on behalf of AlliedServices Integrated Health System.
Zurad said that although people have a tendency to postpone Advance Care Planning, it is a very important subject that must be addressed. He said that at least once a week, someone comes into his office to discuss situations involving health care planning.
“Even though medicine has come a long way in the last 40 years, not a lot of improvements have been made to help with the final transition,” he explained.
What people can do, Zurad continued, is to make their wishes known in the event they later become incapacitated, to help ease the transition, both for themselves and for their loved ones.
Using a booklet titled ‘Five Wishes,’ published by Aging with Dignity, Zurad outlined the various things people can do to help others make certain crucial decisions for them, when they are no long able to do so. The information outlined in the booklet meets Pennsylvania’s legal requirements, as well as 41 other states and the District of Columbia.
The five wishes covered in the booklet are:
1. The person I want to make care decisions for me when I can’t.
2. The kind of medical treatment I want or don’t want.
3. How comfortable I want to be.
4. How I want people to treat me.
5. What I want my loved ones to know.
In the first category, Zurad said people sometimes find themselves unable to speak, write, or otherwise communicate due to a stroke, severe heart attack, or other incapacitating condition. This is why it is so important that people discuss such matters with a spouse, other family member, friend, or someone else they can trust, and provide them with written instructions to see that their wishes are carried out.
Zurad cautioned that health care providers – such as doctors, nurses, and nursing care assistants – should not be the ones making decisions for incapacitated people.
The designated person’s name, address, telephone number and other pertinent information should be easily accessible in the event they have to be quickly contacted.
For medical treatment, Zurad said, people should provide explicit instructions on what they want or don’t want. Some examples include whether or not a person would want to continue on life support if they are near death; in a coma where they are not expected to recover; or have suffered permanent or severe brain damage and are not expected to recover. This can be an extremely difficult decision, Zurad explained, which is why people should record their wishes with a designated person to make certain they are carried out.
Concerning seeing to a person’s comfort who is near the end of his or her life, the person can provide instructions on if they want to have medication administered to relieve pain; if they want to be bathed on a regular basis; if they want to have their favorite music provided until the time of death; and whatever medical, spiritual and emotional care can be provided.
In the category of how a person wants to be treated, one of the most important was expressing the wish that a person wants someone with them when they are close to death.
“In doing my job for the past 40 years, I can’t remember taking care of a patient that wanted to die alone,” Zurad explained. Other wishes in that category include members of the person’s faith community being informed of the situation so they can pray for and visit the afflicted; the person being treated with kindness and cheerfulness, and not sadness; and being permitted to die at home, if possible.
Wish Five contains a long list of desires that a person can express to loved ones. One of the more important ones concerned how people remember the afflicted, before said person became seriously ill. Zurad said he’s seen many times where family members will take children to visit their grandparents who are near death which turns into a very sad experience due to their condition.
“People want to be remembered as very vital and energetic,” Zurad explained. “It can really helpful if loved ones emphasize positive memories under such circumstances.”
Other important information covered in this category include if a person wants their body cremated or buried after death, and what person has the necessary information concerning the deceased funeral.
During the question and answer period, Eva Dieffenbach of Tunkhannock asked if the booklet is considered a legal document, which Zurad confirmed.
Marcella Jervis of Tunkhannock asked if the booklet, is similar to a living will. Zurad said it is a living will, and also explained that the booklet goes a step further by granting power of attorney to a designated person if the person using the booklet becomes incapacitated.
Shirley Swenson of Tunkhannock inquired if copies of the booklet containing a person’s wishes can be provided to other people. This is possible, Zurad said, and even recommended, because it allows the person using the booklet more of an opportunity to make their wishes and insure that they are carried out.