Mark Harvey — The first word in “living will”


Does everybody remember where we are in this discussion? Good, then I’ll quit wasting half the column reintroducing the whole thing and just move on, OK? Thank you.

We’re about medical decisions when you can’t make your own, and last week we danced all over and around Durable Powers-of-Attorney Health Care, so (Hopefully!) you’ve given that some serious thought; if you have, I’ll bet that your “serious thought” led you to the same place that my “serious thought” led me: Where do “living wills” fit into all this?

Well, OK, you may have used other terms like “advance directives” or “health care directives” or “directives to physicians” or whatever, all of which are fine, because they all basically refer to the same thing, so I’m just going to use the term “living will,” OK?

A “living will” is a document that tells your doctors and/or other health care providers when you want them to stop life-sustaining medical treatment and let you die. Sounds a bit … stark, doesn’t it? It is, so this might be a good place to stop for a moment and apply a bit more of that “serious thought:” Do you really want to sign a document that tells people, who might be able to keep you alive, to let you die?

The answer is that many people do — and many people don’t. If you ‘re serious thought places you in the latter category, and depending upon what you’ve decided to do about of DPOA for Health Care and what you’ve decided to include in that document, you may want to stop here, and give your “serious thought” the rest of the day off.

For others of us who feel rather strongly about these things, we’ll proceed. There are only two situations in which a living will can take effect:

1. You’re terminally ill and will die soon, so that life-sustaining procedures would only prolong the process of dying, OR …

2. You are in a permanent unconscious condition.

“Life-sustaining procedures” include things like manual or mechanical efforts to restore heartbeat or breathing when they’ve stopped (think “CPR,” or a respirator), but there are many more. They do NOT include procedures needed to ease pain, so you’re going to get those, regardless of whatever else you decide.

Yes, that is a relief.

Now, harken back (What?! You’ve never “harkened” before?? Well, here’s your chance!) to last week’s discussion about Health Care Powers of Attorney, because the person you designated to make those decisions could be making decisions about a whole lot MORE that life-or-death, right? Right; so, having a “living will” in place could actually help guide that person through what is usually a very difficult time, so it would be very smart to have both.

Among folks who want to have a living will place, there are very different views about whether food and/or water should be given artificially (intravenously, etc.), so you can decide whatever you want to decide about that.

To be valid, a living will has to be signed and dated in the presence of two witnesses, both of whom must also sign. They cannot be:

1. Related to you, by blood or marriage

2. Entitled to inherit anything from you

3. People you owe money to

4. Your attending doctor, or anyone in his/her employ

5. An employee of a health care facility in which you are a patient

All of which make a lot of sense.

Sign at least two copies. Keep one for yourself and give one to your physician and/or health care facility. Some of us scatter them hither-and-yon (after we’ve finished harkening) to every health care provider we ever see or any facility that could conceivably be on our horizon, which is really not a bad idea, UNLESS we decide to change our minds!

Oops…Can we change our minds? Sure! You can cancel a living will any time. All you have to do is destroy it, or have someone else destroy it, in your presence; OR, you can do it via a written cancellation, that you’ve signed and dated, OR you can just tell your doc to forget it! So, the more places you’ve put them, the more places you have to go to retract them, but such is the price we pay for pre-planning.

And remember, if you can speak for yourself, no one is going to care diddly about your little living will.

AND, you’ve probably figured out by now, courtesy of your “serious thought,” that it would be smart to have conversations about this with … your doctor? Health care facility? Family?

YES! Well done!

Some of you are thinking, “So, where can I get a form to help me do this?” Well, you could go to http://www.washingtonlawhelp.org/ and click on the “60+” icon and look for “living wills.” We’ve talked about “WashingtonLawHelp” before: It’s a reliable, free web site maintained by the Northwest Justice Project, and has a lot of great info. You’ll find a form at the end of the leaflet on living wills.

Will it work? Yes. Do I think it’s the BEST idea? No.

I think the BEST idea is to sit with an elder law attorney and get a whole “package,” that would likely include will/living will/durable power of attorney for health care (maybe a general “DPOA”) and possibly a “community property agreement.” I think this is the BEST idea because those folks are very skilled at helping us to think-through contingencies, then producing documents that reflect what we want. But, go your own way, and I realize that finances are what they are.

OK? For those of you who are stuck in the “serious thought” mode and are thinking, “What about a POLST form?” Well, you can think of a POLST (“Physician’s Order for Life-Sustaining Treatment”) as a kind of “specialized” living will, designed for those who have a condition such that they could go … suddenly; true, any of us could, but those of us who live with it know who we are and what this means, so we’ll let it go, for now.

Has our “serious thought” h ad enough? Mine has, so give yourself a little break, then think about it and (Better yet!), talk it through with someone you trust; sometimes, hearing yourself say it can be very different from just hearing yourself “think” it.

And remember that the first word in “living will” is living.

Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information &Assistance.

 

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