Preparing for death is important – if you want to make your own choices. If you do nothing, the medical community will keep even the frailest alive as long as possible, often with prolonged suffering and at great expense to families. Your next of kin, as soon as it can be determined, will be your Power of Attorney or Health Care Agent to make decisions for you in the event you are unable to do so. If you prefer other options, then you need to plan ahead.
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Most people do not realize that the Patient Self-Determination Act gives them the right to Allow Natural Death, such as Do Not Resuscitate (DNR) orders and other limits on the use of life-extending measures, as they get Dementia or near the end of their lives. You can initiate signed and witnessed documents that provide support for the medical community to honor your wishes. Without them, medical providers or your Power of Attorney may face legal limitations to honor your wishes to allow natural death without potential allegations of neglect or abuse. These documents can also prevent over-treatment that profits the medical industry at great cost to families and the government. Of course, you need to make sure everyone involved in your care has a copy of these documents.
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ADVANCE DIRECTIVES: LIVING WILL and POWER OF ATTORNEY or HEALTH CARE AGENT
Every adult should have Advance Directives to designate a Power of Attorney or Health Care Agent and a Living Will that may request DNR orders or other instructions in specific circumstances.
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Advance Directives by State. This blue link provides legal documents by state from CaringInfo.com. They include a signed and witnessed Living Will to broadly describe your medical wishes and designate of a Power of Attorney or Health Care Agent to make medical decisions on your behalf if you are unable to do so. Some states also include your wishes for Organ Donation or the Disposition of Your Remains. Ideally, make sure your Power of Attorney lives nearby and is willing and able to honor your wishes.
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Five Wishes. This blue link goes to alternative Advance Directives that can be customized by state to describe your Five Wishes: your Power of Attorney or Health Care Agent to make health care decisions for you when you cannot, Living Will for the medical treatment you do or do not want, as well as how comfortable you want to be, how you want to be treated, and what you want your loved ones to know. These must also be signed and witnessed.
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PHYSICIANS ORDERS or MEDICAL ORDERS
As you get older or have chronic illnesses, you will also need Medical Orders and other documents to clarify your options.
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Physicians Orders for Life-Sustaining Treatment by State. This blue link provides state-specific documents to be signed by your medical provider for those nearing the end of life, such as Medical Orders for Scope of Treatment or Physicians Orders for Life-Sustaining Treatment (MOST or POLST). These medically authorized documents often include DNR orders, but may not include other options for end-of-life care, such as options to Allow Natural Death if you have Dementia. These documents provide legal support for medical providers to honor your wishes. Make sure to keep a copy with you and give copies to your family, Health Care Agent, and all of your medical providers.
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Note that EMERGENCY Medical Staff are REQUIRED TO DO ALL THEY CAN TO SAVE YOUR LIFE. But, if you want DNR or other choices, you will also need to post a copy of your MOST or POLST ideally on BLUE paper on your Door or Refrigerator – Emergency staff prefer to see the document. You can also order a DNR Bracelet or Necklace from American Medical ID or another vendor to let Emergency staff know that other choices have been approved.
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OTHER DOCUMENTS
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My End-of-Life Decisions: Advance Planning Guide and Toolkit. This blue link is to Compassion and Choices’ comprehensive toolkit that includes additional documents that you will need to convince medical providers to honor your wishes in specific circumstances. These includes documents related to Dementia, guidance for Medical Providers, and riders for those in Hospitals, Assisted Living, or Nursing Homes. These signed and witnessed documents should be added to your Advance Directives, given to your Power of Attorney or Health Care Agent, and given to all of your medical providers.
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Dementia Values and Priorities Tool. Although this is in the Toolkit above, a blue link is here again to this document that specifically helps to communicate your wishes for future care if you are living with Dementia. For example, it outlines very specific options to allow natural death. It should also be added to your Advance Directives and given to your Power of Attorney or Health Care Agent and your medical providers.
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Medical Aid in Dying. This blue link shows the laws several states have passed that allow medical aid in dying to those who are terminally ill, and expected to live six months or less, to die peacefully if their suffering becomes unbearable.
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LGBTQ+ Advance Care Planning Toolkit. This blue link is to a step-by-step guide written by and for the LGBTQ+ community to prepare for their unique healthcare needs and end-of life decisions.
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Getting Your Affairs In Order Checklist: Documents to Prepare for the Future. This blue link goes to a list of documents that you will want to have ready for your loved ones. These include Wills, Insurance information, and Financial documents whereby you can designate your Beneficiaries in advance. The US Department on Aging also offers a seven-week email series that can help you plan and prepare these documents. Also please make sure that your partner and/or the executor of your estate are familiar with and know where to find all of this information before it’s too late.
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Consider coming for a Free Introductory Session to explore what brings you to coaching and how I might be able to help you on your journey.
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“Keep me away from the wisdom which does not cry,
the philosophy which does not laugh,
and the greatness which does not bow before children.”
-Kahlil Gibran