Where there's a will...

...there is less debate, less stress and strain, and ultimately less suffering and difficulty for the family.

I'm referring to a living will and health care power of attorney documentation. Between my internship work in cancer patient support and my current work with cardiac patients this topic has been brought to my attention on several occasions. Initially I thought nothing of it, as I felt it was something I didn't need to be concerned with for many years. Over the last few years however, following encounters with patients and their families I have grown to understand the true value of these simple pieces of paper.

On more occasions than I'd care for, I have watched as a family agonized over what must be the most intense decision possible...whether or not to cease care on an ailing loved one. Our initial urge, I think, is that this is a no-brainer. Do whatever it takes as long as it takes to give me a chance to have my loved one stay around. Or, on the other side of the coin..."well mom has been suffering for quite some time, she has lived a good life". And on some occasions, it can be a relatively comfortable decision. More often, it's when things are sudden, not according to plan, when suddenly a seemingly completely healthy 50 year old man collapses with a heart attack and is on a ventilator. Just yesterday I was playing golf with him, surely he'll recover from this. How hard is it as a family member to sign to cease support and treatment then? Or possibly worse yet, when it's a child.

There are numerous benefits to these documents (living will and healthcare power of attorney). Most obviously that it ensures that your personal desires and wishes are carried out when you may not be able to do so personally. From my perspective, that of a counselor working with patients and families, is the piece of mind it can provide to family members. Often times even when it has been discussed, even in a loved one I've known and been family with for years, that final decision to cease care can potentially be extremely difficult. Sometimes just having a piece of paper, justification for the decision, something that reminds us "this is what he wants" can relieve significant amounts of strain.

In one final scenario I have seen involves a family member on life support after an unexpected event. His children, siblings, nearly all of his family has accepted the current situation and are ready to withdraw care...however, no documentation exists and he has a new wife, who by law, is next of kin and now in control of the decision by default. Now whichever side you agree with, what is clear is this would likely cause stress at the least and family tension, anger, and many other possibilities.

I'm going to provide some links now that give a little more information, but if you have any questions or concerns ask a lawyer, your primary physician, or your local hospital.

And please, despite age, situation, etc, please consider taking the time to complete these. Encourage loved ones to complete them, and ensure that others know where they are, how to access them, and discuss your wishes. A document is no good if loved ones or medical staff don't know it exists!

I brought it up with my parents a few months back, with no follow through. So in part, this is to remind me to follow up on these matters myself.

FAQ about advanced directive from my place of employment

Living will instructions and basic form

Healthcare: POA form

All in one information resource about end of life choices etc