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Monday, May 18, 2015

What is An Advanced Medical Directive? Who needs one?

Lets now talk about that second document every adult should have "THE ADVANCED MEDICAL DIRECTIVE"

What is it and why is it important?


Your Advanced Medical Directive, your AMD, is another tool that allows you to make your wishes known in advance of a medical emergency so you get the care you want and do not leave your loved ones grappling with the hard decision of guessing 'what does mom or dad would want us to do?'. There are two main areas that you are going to cover with this directive.


1. End of Life Decisions:

You will be electing to either prolong your life at all costs, such as being put on a ventilator or other machine to keep you alive when you can no longer sustain life on your own, or you may chose Not to prolong life if  certain circumstances occur: an example would be
if you where considered brain dead and prolonging your life would leave you in a vegetative state. YOU make the decisions now while you are still sound of mind for something that may or may not happen, and you relieve your family of the burden of (as we have all head the term) "pulling the plug".

Many older people like my own mother who is now 91 have chosen to put in what is called a DNR order. This term means "Do Not Resuscitate". So she has told the doctors if her heart stops she does not want to be revived. Why would she want that? Well her health is declining, she cannot see or hear well at all and caring for herself is becoming increasingly difficult. And when her heart gives out she has made it know that enough is enough and she will wish to go in peace. We will honor her wishes, we are not in her shoes and everyone makes their own decisions. We are glad that she has her AMD and her DNR so we are not left to make decisions that may otherwise have left us guilt ridden for years, wondering if we did the right thing.


2. Relief From Pain:

In this section you will state if you want to be kept out of pain at all costs even if treatment for the pain hastens your death.  You will have in this section a place to write in exceptions. Pain is a very had thing to deal with and when it comes to end of life, the medications used to treat the pain may bring on death faster. However if you are not going to recover and death is inevitable, you may chose to be out of pain until you pass. Again this takes the decision out of the hands of your doctors and relatives and instead allows them to keep you comfortable during your final days and hours.


3. Other Wishes :

You may chose to write in you own specific choices as to care and this additional section allows for that.

Don't wait until you are sick! Do it today.

Once you have completed this document you will leave it unsigned until you are in front of a Notary and two witnesses. Once signed and notarized you will then want to make copies of this for?
  1. Your primary care doctor,
  2. Your patient advocate ( I will discuss a bit later) and
  3. Family members who are likely to be with you in an emergency situation.
The original should be kept in a safe place such as a safety deposit box.  

Now some forms allow you to combine your Advanced Medical Directive with choosing a Power of Attorney for Health Care also called you Patient Advocate. This person and a successor person, in case the first person is not available, are chosen by you in writing to speak on your behalf in medical situations, should you not be able to speak for your self. That is why these people should have copies of your AMD so they know specifically what your wishes are. Open and frank discussions should be had with them about your wishes.

If this seems confusing it really is not. Just take some time to print off and read the forms and it will all make sense. If you would like you can consult an attorney, or for much less cost, consult an elder care specialist in your area. Their fee is usually much more reasonable and they will walk you through the whole process. The key is to do this all in advance, well in advance of when you will need it. Don't wait until you are sick! Do it today.


Take Care,

Ruth Anne


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