If you’re one of my patients, or the family of one of my patients, I’ve already nagged you about this: Make out an advance healthcare directive: Figure out whom you would want to make your health and legal decisions if you become unable to do so. Think about what you want to have done if you are critically ill: Do you want everything done to prolong life? Or, are there certain procedures you’d like to avoid, such as a tube to help you breathe with a respirator?
As a culture, we are not very good at talking about endings. So only a small percentage of people actually prepare these forms, but they’re essential if you want to avoid treatments that are more aggressive than you would want, or if you want to keep an unscrupulous nephew, or whoever, from taking over your affairs and your medical decision-making power. Please, please, please, make your wishes known before it’s too late. Or make sure that your loved ones do.
But here’s the other thing you need to know: If you go to all the trouble to prepare advance directives, they won’t be followed if loved ones don’t know where they are, or if they’re locked in a safe deposit box or some other secret spot. If the EMTs show up at your doorstep, and you’re unconscious or unable to communicate, they can’t follow a “Do Not Resuscitate” (DNR) order, if they don’t actually see a signed, witnessed copy of that document.
So what to do? Luckily, we live in the digital age. The American Bar Association has developed a free, smartphone app called “My Health Care Wishes.” The app will store all your advance directives on your phone. And most of us have a phone around pretty much all that time, so mischief managed. If your elder doesn’t have a smartphone, the documents can be stored on a family member or caregiver’s phone. The app works on both Apple and Android phones.
You can also store healthcare directives digitally in other ways: For $45 a year, Docubank will make your directives available with a phone call. MyDirectives makes available a Universal Advance Digital Directive (uADD)™ for free, from a web-based database. It makes money by charging healthcare providers to access the database.
At the very least you can post on the refrigerator along with emergency contact information, current medications and illnesses to help the EMT's if they are called in an emergency. Emergency personnel are trained to look at the refrigerator for such information in homes.
Be sure to have a conversation with your family, friends and especially your 'agent' -the person who will be making decisions for you. Be sure they know not only what your wishes are, but where you keep your important papers, as well as have access to your computer and phone passwords.
So the directive templates are out there. There are ways to make them easily available when a problem comes up. You don’t have any more excuses to avoid completing a directive.
Just do it. Please. You and your family will not be sorry.
Elizabeth Landsverk, MD Specialist in Geriatrics