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An Advance Directive
By Marilyn Mitchell

(Page 2 of 2)

No one plans on getting into an auto accident, yet most adults have been in at least one.  With about 6 million auto accidents annually in the U.S. and hundreds of thousands of injuries, it would seem reasonable for anyone that has a driver's license to be required to create an Advance Directive.  We all get to decide if we want to be organ donors at the DMV; why not also decide to designate someone to speak for us if we are unable to due to an accident?

Creating an Advance Directive may be very important for anyone's future; yet even more important are the conversations you have with family and friends regarding your wishes. That way you will know that several people are able to communicate your wishes. It may not seem like festive holiday banter, but discussions about these issues are becoming more important than ever because we live in an aging society.

Helping a loved one create an Advance Directive if they’ve begun the process of dementia is still possible in the early stages. Most people have fluctuations of their mental abilities as they succumb to dementia. You may recognize that your loved one is more capable of speaking and understanding conversations at certain times of day. Discussing an Advance Directive when that person is at their best time mentally would be ideal.

Discussing one’s Advance Directive with one’s primary care physician is also vital to the process. They can help to explain any misconceptions and answer any questions about treatment. Unfortunately in today’s medical world, primary care physicians are often not the ones in the hospital at your bedside if you’re admitted; it’s often a hospitalist­, a physician that specializes in inpatient medical care. But having had the conversation with your primary care physician is essential for you to feel informed about your choices. That way, if you are admitted unable to communicate, your Advance Directive will have been made with the consideration of information provided by your primary care physician. 

Next. You've created an Advance Directive; now what do you do with it? It's important that it doesn't end up in your safety-deposit box where it will do no good if it's needed. Send a copy to your primary care physician. If your medical system is computerized, it will be scanned and added to your chart. Keep a copy somewhere others can easily find it. Give a copy to the person you named as your 'durable power of attorney for health care.' That way, they will know in advance what your wishes are. It may stimulate even more conversation that could be very helpful if your surrogate is indeed called upon to assist a medical team with decisions for treatment.

Personally, I think every person that drives a car should write an Advance Directive every five years. I recommend updating regularly because technology changes, and some of your choices may seem incorrect as technology makes life more feasible despite disabilities. For example, there are some people that might write into their Advance Directive that they would rather not be kept alive if they are unable to speak, but there is research that makes the possibility of communicating using only your thoughts and a special computer very likely in the near future.  Every person over age 65 should be required to create an Advance Directive since it is very likely at some point they will be relying on health professionals to care for them. Wouldn't you want your wishes known?

 


 

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