After 30 years of building a career in the health care industry, I have learned that one’s life can change in the blink of an eye and we must plan accordingly. We may not be able to control the incident that causes a significant life change, but we can take advantage of the resources made available to document our wishes.
On October 10, 1991, Ohio’s Advance Directives Law, Amended Substitute Senate Bill Number 1, became effective. Senate Bill 1 addresses both the Living Will and the Durable Power of Attorney for Health Care, and makes provisions if no advance directive has been executed. Under the new law, Ohioans can execute a living will and/or a durable power of attorney for health care to indicate their preferences for future health care needs. The amendments in this Senate Bill 1 were intended to improve and clarify the terms of the Sept. 27, 1989, original statute.
The Federal Patient Self-Determination Act (PSDA) which went into effect on December 1, 1991, requires that all Medicaid and Medicare providers inform patients of their rights regarding self-determination for health care and record whether the patient has executed an advance directive.
So, you see advance directives have been a part of the American health care conversation for years, but they’re still relatively rare. Approximately two-thirds of the adult population has never executed their advance directives. A vivid reality, in part, of why our health care system may be broken. Studies revealed that of those that were completed, they were shoved in a drawer at home where doctors nor family members were aware they exist.
I recently read a story of a physician watching his father die the wrong way. At age 78, he was laid out by a stroke, hooked up to a ventilator and an intravenous (IV) drip in ICU, his last hours spent in a hospital. It was the most aggressive care modern medicine could offer, and the family later came to understand that it was unlikely to save him. It was not how he wanted to spend his final days. Unfortunately, this happens to millions of Americans.
It is important to understand that your physicians, your parents, your spouse, your children, siblings, significant other, step-children, etc., all could have very different beliefs. With these varying beliefs comes different opinions surrounding life and death situations. Perhaps, for some, it’s just the unrealistic belief that our loved one will regain consciousness and be completely normal again. These situations can tear an otherwise close-knit family to threads.
While this conversation may be uncomfortable for most people, it is my passion to share what I have learned to ensure that every person understands the importance of executing their advance directives. And, if necessary, making sure that your wishes are carried out. What medical treatment would you want done? Shall they perform CPR? Shall they intubate and place you on a ventilator?
If you make a conscious choice not to execute advance directives, you are placing a significant burden on your family members to try to come to an agreement on what your wishes would be. And, of course, there’s that dreaded situation where perhaps not all your loved ones agree on what you would want in the way of medical treatment. Typically, the medical practitioner will follow the family hierarchy, but there have been instances where, if it comes down to life or death and there is much uncertainty among the family as to whether you would want to be placed on life support or not, the medical practitioner may place you on life support until a final decision can be made. Perhaps it escalates to a courtroom and becomes a lengthy legal battle.
Do you want your family torn apart through despair and hostility or, would you like them to remain united, to celebrate your life’s work together and, carry on your life’s mission?
I want people to think about advance directives as an obligation. To not only execute your durable power of attorney for health care and/or living will, but to share this information with your family, your physicians, your hospital and to store this legal document with all your other important documents.
Advance directives consist of a durable power of attorney for health care and a living will. Not to be confused with a financial power of attorney or last will and testament. The State of Ohio made these documents free and accessible to all adults in Ohio. They can be executed by indicating your specific wishes on the document and signing in the presence of a notary public or two witnesses unrelated to you and not a caregiver, nurse, or administrator responsible for your care unless that individual is related to you.
Georgiana Saffle is the founder of Advocacy Professionals