Su Lum: Slumming
June 8, 2011
I thought I knew everything there was to know about all the end-of-life directives, but my friend Belinda Frishman recently set me straight. It is not enough to have a Do Not Resuscitate notice on your bedroom door or even a Do Not Resuscitate bracelet on your wrist, and it is certainly not enough to have a Living Will and power of medical attorney form in a safe deposit box in the bank.
The most important thing you need to do, if you recoil at the idea of being hooked up to machines to keep you alive when you’re as good as dead, is to fill out the one-page Advance Directive for Surgical/Medical Treatment (Living Will) and make sure it is entered in your hospital records so that it will pop up first thing when your name is entered into their computer.
In Aspen, you can get this form at the reception desk at Aspen Valley Hospital and, after you have filled it out, return it to the reception desk and they will enter it right away. The form itself is simple and direct and is not triggered by ordinary maladies or mishaps, but only if you are in a certifiably terminal or in a vegetative state.
In the same booklet, “Your Right to Make Healthcare Decisions,” is another simple form to name the agents who can make medical decisions for you in the event you’ve lost your marbles and can’t communicate. This is very important because it gives your agents access to your medical information which would otherwise be confidential. You can name one agent and two alternates.
If you do nothing else, get these forms into the system. Medical personnel are, after all, trained to do their best to save your life and keep you alive, and it’s up to you to help them to know when to stop, as well as sparing your loved ones from having to make the decision to pull the plug.
Do Not Resuscitate forms need to be filled out and signed by your doctor. My mother had DNRs all over her bedroom and on her wrist, as well as having directed all of her family and caregivers not to call 911 no matter what happened. She was bedridden, was in her mid-90s and had several life-threatening conditions, so this was appropriate for her. She was able to live at home and broke some New Jersey records for hospice care (four years) before drifting away in her sleep at the age of 99. You don’t want to play fast and loose with DNRs unless the end is really in sight – stick with the Advance Directive form.
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The Five Wishes booklet is a more extensive and nuanced form of the Advanced Directive. I got mine from Mary Barbour up at the Senior Center and Mary says it is becoming quite popular nationally. It goes into more details regarding your wishes for medical treatment, how you want to be treated, what you want those close to you to know, and encourages you to write in as much length and depth as you care to.
The Five Wishes are an excellent starting point for discussion with family and friends (throw a Five Wishes Party and compare answers), but if you are whisked to the emergency room the Advance Directive is what your medics will be more likely to look for in the computer – short and sweet.
Ideally, after getting the Advance Directive into the hospital computer, you should keep that form and the Five Wishes (and DNR if you have it) in a manila envelope tacked by the front door, tell your agents where it is and give them copies. Put your doctor’s name and phone number on the envelope and note that you want your doctor notified of your hospitalization. You can also ask that your own doctor admit you rather than whoever is on call at the hospital.
Of course all of the above presupposes that you are going to go down within range of your specific hospital. If your records are at Aspen Valley Hospital, I’m not sure what will happen if you get hit by a bus in Glenwood Springs, much less if you’re in foreign lands.
One day I imagine we’ll all wear information chips.
Spurred by Belinda, who began looking into this for her own sake, Aspen Valley Hospital is fine-tuning its policies and will be holding information forums with the public later this summer. I’ll be sure to let you know when and where.