Toolkit Offers Assistance on Advance Planning for Health Care

Dorian Martin Health Guide
  • You would think that reaching mid-life and going through menopause would signal a certain level of maturity and knowledge. Well, it does, but there are many, many issues that can emerge that can make you realize how much you still have to learn.

    Let me give you an example. I recently sat with an elderly relative in a hospital intensive care unit. When a surgeon came into the room to evaluate the elder’s health status, the recommendation was made to have emergency surgery. “What are the other options?” we asked. “It’s either surgery or death,” the surgeon said. Then the anesthesiologist came in and started talking about what the elder’s wishes were if things started to go wrong during surgery, such as if his heart stopped. The elder looked at me for my view on the subject. “This has to be your call,” I told the elder, adding that I was willing to make the decisions if he ended up in a vegetative state after surgery. Fortunately, that didn’t happen and the surgery was successful, but that experience did make me realize that (1) I hadn’t had the depth of conversations with loved ones to understand their wishes in these types of situations; and (2) I had not really thought through what I personally want when and if I am placed in these types of situations.

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    I am sure that there are other women who are finding themselves in similar situation. That’s why I want to use this sharepost to make community members aware of a really valuable resource to guide your own decision-making process on these issues as well as discussions with loved ones (such as a partner or aging parents). This resource is called the Consumer’s Toolkit for Health Care Advance Planning, which is put together by the American Bar Association’s Commission on Law and Aging.

    “Good advance planning for health care decisions is, in reality, a continuing conversation – about values, priorities, the meaning of one’s life, and quality of life,” the ABA publication states. The publication doesn’t create a formal advance directive, but it does help guide you and love ones on what is described as “the much harder job of discovering, clarifying, and communicating what is important to you in the face of serious illness” through using 10 tools.

    The tools in the publication include the following:

    • Selection of a person to serve as your health care agent or proxy.
    • Discussion about whether some conditions are worse than death.
    • Weighing odds of survival.
    • Identifying personal priorities and spiritual values that are important when making medical decisions.
    • After-death decisions.
    • Conversation scripts in order to get past the resistance of talking about death.
    • A proxy quiz for family and a physician.
    • Steps to take after signing a health care advance directive.
    • A guide for health care proxies.
    • Resources for advance planning for health care.

    The publication offers thought-provoking scenarios to help you (or your loved one) think through wishes. For instance, you are asked whether you want treatment or have treatment withheld in a variety of scenarios, such as the following:

    • Can no longer recognize or interact with family or friends.
    • Can no longer think or talk clearly.
    • Can no longer respond to commands or requests.
    • Can no longer walk, but can get around in a wheel chair.
    • Can no longer go outside and must spend all day at home.
    • Have severe pain that is not treatable most of the time.

    Additionally, the publication is really valuable because it encourages you to reexamine health care wishes and alter advance directives (if necessary) at the following points of time:

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    • Starting a new decade in your life.
    • When a loved one dies.
    • When experiencing a divorce or other major family change.
    • When diagnosed with a serious health condition
    • When there’s a significant decline in health or deterioration of an existing health condition, especially when it diminishes the ability to live independently.

    I’d encourage everyone to download this guide and read. Take time to have the conversations with loved ones and to also think deeply about what you want. This will be time that is very well spent!

    Primary Sources for This Sharepost:

    American Bar Association Commission on Law and Aging. (2005). Consumer’s toolkit for health care advance planning, second edition.

Published On: June 23, 2014