HEALTH SENSE
Consider an advance health care directive By Sara Patterson
O
ur entire lives we are taught to plan and prepare for our future: school, college, retirement, etc. One thing that we’re we are not taught to plan or prepare for is the end of life. Discussion about death and dying is a scary topic and therefore often avoided. Yet the best time to talk about and document your health care wishes and after-death preferences is while you are healthy and of sound mind. Starting the conversation now builds a foundation and normalizes the topic. Advance care planning is not just about old age. At any age, a medical crisis, disease or severe injury could leave you unable to make your own health care decisions. Planning for health care in the future is essential. Do you have a plan? Have you thought about who would help guide your medical decisions if it meant life or death? What kind of medical treatments would you be willing or not willing to receive? The process of working through these questions and talking about them is called advance care planning. Advance care planning explores the kinds of decisions that you will need to make. If you choose to formalize your choices, you would do so on a document called an Advance Health Care Directive, or AHCD. We all have values and preferences that relate to health care. It’s important to think about these values and preferences, discuss them and write them down in an AHCD. Having an AHCD, also known as a living will, ensures your preferences are understood and respected in the case of a medical crisis, disease or severe injury. There are two parts to an AHCD.
Part one allows you to name a surrogate decisionmaker, called a health care agent, to be your voice and help guide your medical decisions in the event that you’re unable to do so yourself. After choosing this person, it’s important that you get their permission to ensure they’re willing to take on that role and responsibility, if ever needed. It’s also critical to have a conversation with them about your documented health care wishes in the AHCD, this way will have an opportunity to ask questions and verify their understanding. Part two goes into detail about your preferences for medical treatment. If you are unable to speak, it’s likely you are very ill and need treatments to prevent you from dying. These treatments are called life-support or life-prolonging treatments. Life support treatments may include cardiopulmonary resuscitation, artificial ventilation (breathing machine), artificial nutrition/hydration (tube feeding), and dialysis. If you have questions about these treatments, consult your primary care doctor. Life-support treatments may be used when it is expected that you will recover and the treatment would therefore be temporary. Some, more serious, situations might require treatment for the rest of your life such as a breathing machine. The topic of death and dying cannot
be ignored when you face a serious or terminal illness. It suddenly becomes necessary to discuss health care options with your loved ones and health care providers. The hardest time to start an advance care plan conversation is when you are told your time is short. Making decisions about unknown health care situations can be difficult, and there is no right or wrong answer. The best way to make your decisions is to base them on where you’re at in your health now and how the treatment would fit within your life goals, values and beliefs. You need to weigh the potential benefits (help) and burdens (harm) from the treatment as it relates to you. Discuss your particular illnesses and treatment options with your doctor and ask how they may help or harm you. Planning and making decisions about life-prolonging treatments can be emotionally difficult for you and your family. But it can also be comforting; if your loved ones ever need to make decisions on your behalf, they will know what you would want. They’ll have peace of mind, and you can feel confident that your wishes are known and understood. If you are ready to complete an AHCD or need assistance, Foundation Health Partners offers AHCD sessions, “Your Life – Your Design.” These sessions are free, they’re open to the public and they occur quarterly. Three sessions remain this year: Friday, April 17; Wednesday, July 15; and Wednesday, Oct. 14. All sessions are from 1 p.m. to 2: 30 p.m. in the McGown Room at Fairbanks Memorial Hospital. For more information about “Your Life – Your Design,” please contact Sara Patterson with Foundation Health Partners Palliative Care Department at 907-4585102.
AlaskaPulse.com — March 2020 — ALASKA PULSE
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