You are probably familiar with a living will. You may have even prepared one. There’s another document, though, that can possibly be just as important—but it’s one only one third of Americans have.
It’s called an Advance Directive for Health Care, and it is a way to communicate your wishes if you are facing a serious or life-threatening illness and are unable to speak for yourself. It aides in the communication between your doctors, the hospital staff, and your family.
Although there are many topics covered in a living will, I consider those more general when it comes to health care. What the Advance Directive covers is all the gray area and the specifics. It clearly outlines the type of care you desire based on your values, goals, and how you define quality of life.
In the state of Tennessee, the Advance Directive goes over four different qualities of life and gives you an opportunity to say what you would want to happen should you end up in any of those states.
You can use the Advance Directive for Health Care form to tell your doctor you want to avoid life-prolonging interventions such as cardiopulmonary resuscitation (CPR), kidney dialysis, or breathing machines. You can use this form to tell your doctor you just want to be pain free and comfortable at the end of life. You can also add other special instructions or limitations in your form.
The form asks what you want to happen should you be in a permanent unconscious condition, permanent confusion, dependent in all activities of daily living and end-stage illnesses.
If you do not have your wishes written down and you have no family with you in the hospital, our default is to do everything to keep a person alive. If you have nothing written, but have loved ones alive, we look to them for advice.
This is where these situations get really difficult, because if you haven’t talked with your spouse or your adult children about your wishes, then the burden of making these decisions falls on your family.
One of the biggest things I think an Advance Directive is for is releasing that burden from your loved ones to have to guess what you would want. It is a true gift of love. I deal with a lot of guilt over the fact that families never talked about it. So, if you aren’t going to do it for you, do it for your family members.
80 percent of people say they want to avoid the ICU or a hospital stay the last six months of their life and they want to die at home. This only happens 25 percent of the time because people don’t make their wishes known.
I would say of the patients we see at Williamson Medical Center, only 25 percent have an Advance Directive, or Advanced Care Plan. My guess is that people don’t want to talk about the ‘what ifs.’ I know that it’s not a fun Sunday dinner conversation, but it’s a serious one you should carve out time to have. Even if you do not fill out the form, have the conversation. It will be on that is remembered and will guide your loved ones.
Completing an Advance Directive is as easy as searching for the form on TN.gov, the State of Tennessee’s website. You don’t have to get an attorney involved. You just print the form, fill it out, and have it notarized or have two witnesses sign it.
Once you have the form filled out and witnessed, all you have to do is give a copy to your doctor and they can put it in your electronic health record, so no matter where you are, it should show up.
Shari Seaman, PA-C, is with the Supportive and Palliative Care Interdisciplinary Team at Williamson Medical Group in Franklin, TN. For more information, visit www.WilliamsonMedicalCenter.org
Here is a great resource on this subject if you would like to get more information or find and print the Advance Directive paperwork: