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Like taxes, death is certain, do you know how to prepare? *

The room was small, but the questions were huge.

What kinds of treatment would you want — or not want — if you are dying?

How do you choose someone to make medical decisions for you if you are incapacitated?

What happens if you don't know anyone you can ask?

In a meeting room at the Frisbie Senior Center in Des Plaines, attorney Kathryn Casey was talking about how to plan for medical decisions at the end of life.

Ten men and women sat at round tables, listening intently. They were at an age where the subject was of particular interest. They considered the matter so private that they did not want their thoughts aired publicly. But they had been thinking, hard.

"You don't want to be a burden to your family," said one man.

"I think this is something seniors need to know," said a woman with white hair and blue eyes. "We vaguely know about it, but we don't do anything about it because we don't know who to go to."

There will be plenty of opportunities to find out in the coming days. In observation of National Healthcare Decisions Day, which is Monday, hospitals and hospices throughout the area will be offering programs encouraging people to complete advance directives spelling out their wishes for medical care at the end of their life.

The most important directive to have, experts say, is the power of attorney for health care. This is a legally recognized document (though no attorney is needed to complete one) that allows people to appoint someone they trust to make medical decisions for them if they are unable to do so themselves.

"It's like the patient speaking," said Dr. Kathy Neely, chairwoman of the Northwestern Memorial Hospital Medical Ethics Committee and assistant professor of medicine in the palliative care service at Northwestern University's Feinberg School of Medicine.

A power of attorney is far more useful than a living will, she said. A living will goes into effect only when a patient is facing imminent death. It does not address what could be temporarily incapacitating conditions like brain injury or stroke. It also speaks only to narrow questions of whether comfort care should be provided.

Everyone 18 and older should have a health care power of attorney, said Karen Nisley Long, vice president of the Chicago End-of-Life Care Coalition and an Illinois liaison for National Healthcare Decisions Day. Accidents can happen, she pointed out, at any age.

But those considerably older than 18 feel the need most acutely. Casey, of the elder law firm Dutton & Casey, had the full attention of her audience at the Frisbie Senior Center as she stressed the gravity of choosing the right health care representative.

"You are naming a surrogate, a person to replace yourself," she said. That agent may have to make decisions on whether to withdraw life-sustaining treatment, "one of the hardest decisions people can make in their lives."

Moreover, "an agent is supposed to use substituted judgment," she said. "That means they are supposed to make the decision you would have made, not the decision they think would be better for you."

They should talk with whoever they were considering to fulfill the role, she said, to fully express their wishes and to make sure the person is willing.

Those talks are one of the primary goals of the campaign. "It's all about the conversation, more than completing the form," said Long, who is also director of development at Horizon Hospice & Palliative Care.

"It's (talking) with the person you've chosen as your agent … about your values and beliefs as they relate to health care: What's important to you, should you be facing a situation where you were very seriously ill? Would it be important for you to be able to communicate with your family? Would it be important for you to be kept alive under all circumstances?"

And is it important to you to avoid a nasty fight in a hospital room when family members disagree on your care?

"This is a gift to your family," she said. "If this is well done, the family doesn't have these horrible disagreements in the middle of a health care crisis. It prevents that … and just think of the burden it takes away from the guilt of the decision-maker."

Maybe you are elderly and finding the issue germane. Maybe your parents are elderly and you can picture a crisis a power of attorney could ease. Or maybe you have already known the heart-pounding feeling of making a judgment in a crisis, and expect to know it again.

We can all imagine circumstances that would be made easier with advance directives. National Healthcare Decisions Day is the day after Tax Day for a reason. There are two things in life that are famously said to be inevitable for us all. This campaign is about the other one.

Article Source: http://freelegalinformation.info

By Barbara Brotman, Chicago Tribune

© 2006 - 2016 Free Legal Information.info

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