Selected Podcast
Don’t Wait Until it’s Too Late: It’s Important to Make Your Medical Wishes Known
Dennis Smith joins this podcast to help increase awareness and share the importance of advanced health care decision making within the community, and to encourage patients to name a health care proxy and fill out their advance directive at the hospital.
Featured Speaker:
Dennis Smith, Bryan pastoral care
Dennis Smith is the pastoral care supervisor at Bryan Health. Transcription:
Don’t Wait Until it’s Too Late: It’s Important to Make Your Medical Wishes Known
Melanie Cole (Host): What kind of medical care would you want if you were too ill or too hurt to express your wishes? Here to tell us how you can go about doing that is Dennis Smith. He’s the Pastoral Care supervisor at Bryan Health. Dennis tell us a little bit about Advanced Care Planning. What is it? And what’s an advanced healthcare directive?
Dennis Smith (Guest): Well an actual healthcare directive is an umbrella term for numbers of healthcare decisions that can be made in advance of an actual healthcare need. These decisions can range from the decision of who one will designate to make healthcare decisions when they are unable to make them. We call that a person that is a healthcare power of attorney. Other examples of directives people can make are how to handle if they have become in a persistent vegetative state, a severe brain injury that cannot be recovered from. Many people would then give directions to their POA to withhold or withdraw life support that is only prolonging their natural dying. Another directive would be whether to be resuscitated if they should have an arrest.
Melanie: So, you are mentioning a lot of issues that come up and people hear these terms Dennis Living Will, Medical Power of Attorney and you just spoke about advanced directives and even physician order for life sustaining treatment. Tell us, what is the difference between some of these terms?
Dennis: Sure. The difference between an advanced healthcare directive and a living will, for me the big difference is that a living will is not identifying a person to serve as a decider for them if they become incapacitated. It just states that the person’s wishes. So, the powers that be at that moment of need, at least have a sense of their wishes. Advanced healthcare directives are more expanded. It can contain living will elements and also allow for the naming of power of attorneys for healthcare.
Melanie: So, what are some of the decisions that could come up and how do people begin that thought process and that discussion with their loved ones?
Dennis: Well, one of the things first off, you know why to have that paper. To not have paperwork on file leaves one vulnerable to get medical care that they may not have wanted. It also may leave one having strangers to make important decisions for them versus having trusted and informed loved ones. On any given day, people travelling on our main highway here in Lincoln, they travel without a spare, ready to go and all the jack tools that are needed. But they may have a successful journey to their destination and not have needed it, but they are gambling and not planning for contingencies. Instead of anxiety, their journey could have been able to have more with a peace of mind as they journeyed if only they had been prepared. And that’s why it’s important to have an advanced healthcare directive. But there are numbers of reasons to have those.
Melanie: So, then how do you start that conversation and what information should be included in that advanced directive?
Dennis: Well, ask yourself the question first. What’s the likelihood that one day I will have a health crisis or likely die? Once settle about that eventuality, begin to plan for it and to put one’s house in order. You seek informed consent. You then speak to people in the know that can give accurate information and to present well the benefits and the risks to one’s choices. This can include medical, legal and spiritual professionals and as you become informed, let your loved ones in on what your thoughts and perspectives are, seeking their input. It’s not uncommon for a family to not see everything the same way. Can you imagine that, a family not seeing everything together? Well, ultimately, you are the one that will sign the document and you will make the final say on what you are wanting.
Melanie: One of the big considerations is choosing that medical power of attorney. How do you select your healthcare agent from the family members, or spiritual care advisers, or lawyers or how do you pick the person that’s going to make these decisions for you should you not be able to make them for yourself?
Dennis: To me the characteristics of a good healthcare power of attorney is someone who is going to be trustworthy. They will carry out what you want. They are a vertebra, they call it, someone who has a backbone. I’ve seen many numbers of times that people choose someone other than their spouse because they believe another person would be more apt to carry out what they are wanting. And also, another characteristic is for someone to be medical savvy. They are able to receive well, information from staff and to communicate clearly and accurately to other stakeholders who have a need to know. They can hear input from others and yet ultimately, make what they believe to be loving choices that align with the person’s values and best interests. It’s convenient if that person is local and able to be on scene, however in our age of technology; a person can work from distances and still do an effective job. The person identified as power of attorney has a stronger say than even kinship. A married spouse is actually equipped even better when identified also as power of attorney.
Melanie: After you set up your advanced directives, where do you keep it?
Dennis: Well, a big thing that I like to recommend to people is for one, you want to keep it in the medical record. You would like to get that there and established because there it is easily faxed and retrieved to give to other facilities with a need to know reason. I like to recommend too that people go ahead and put them on their refrigerator. I also too, would recommend to have one in a glovebox of a car, to have one handy when on a trip. Get them into the hands of people that are important to them. Let them know where the important paper file would be and where these things would be kept so they are easily retrieved. We have had numbers of times that we could have used that information quickly and because it wasn’t made available to the family; it delayed the kind of care that these people should have and could have gotten.
Melanie: Dennis where can people fill out their advanced directives? Can they do that at the hospital? How would they go about that?
Dennis: At Bryan here, there are a number of ways that this can be done. One can be done through the health information people, pastoral care department is identified as a go to place to seek out that. So, when they come to the hospital, they would be able to ask for a chaplain and see if there is one available at that time to do that. The preferred method would be to go ahead and to make an appointment with someone in pastoral care and set up a place to rendezvous and to be able to complete that. Other thing to consider would be too to seek out legal counsel. If they have a lawyer that they trust and would like to set up something in advance that may encompass many other interests for the family; that’s another good route to go too. There are many websites such as Five Wishes and other places that have great documents to be able to consider and see if that would best suit what their needs are at the time.
Melanie: Then as you wrap up with us, share the importance of advanced healthcare decision making within the community and what else you would like the listeners to know about the importance of advanced directives.
Dennis: Well again, to be able to have that paperwork on file leaves one more confident that what they want is actually going to happen. And what happens if someone doesn’t have one? Well, I like to first mention that those who have one on record may get the amount and the type of care that they were wanting. They also may have the people contacted quickly that they would have wanted to have known more promptly because we have phone numbers to access. Those who are not equipped, may have strangers making the healthcare decisions for them, decisions that may not reflect the person’s values and their wishes.
If it’s true that the last three weeks of a person’s life can be some of the most costly; we find that many people are put through procedures and care that they would have never wanted. But they never made their wishes known and so for a family or a business, this could possibly cripple them economically due to that kind of care that they may not have wanted. And then there’s family power grabs that go on when there is not a clearly identified go to person. In the heat of battle, it’s not the time for this determination to be made. A patient’s recovery is hampered by the tension and the bickering that they feel and experience. I think a great free Christmas gift for the family this year could be a clearly stated advanced healthcare directive. You need to remember, it’s valuable, but it is free. We are blessed also that we can have freedom to express our wishes for the type of healthcare we do or do not wish to receive.
I think getting one’s house in order relieves anxiety, stress and chaos not to mention overwhelming expense and emotional turmoil and anguish that could have been avoided. Dying with dignity and the way you want it is not a bad thing. It is in fact, a very good thing. Review and update. Do so every couple of years or sooner if desired. Very mobile society. Addresses change regularly, and accurate phone numbers work best. Children suddenly become of age and then be considered as POAs. One perspective can change with further information and physical changes and so sometimes people become open to DNR when they wouldn’t have before because of a new diagnosis. So, keep updating. And then once in that medical record, it’s easily faxed and retrieved to give other facilities with need to know reason. And also, get it done. Don’t procrastinate. Many say to me I didn’t realize it was so easy. I would have done it sooner if I had known. I fretted for no reason and I’m so relieved to have it done now.
Melanie: Wow, great information Dennis. Thank you so much for coming on and explaining to everybody the importance of filling out their advanced directive and choosing a medical power of attorney because it is so important. Thank you again for being with us today. This is Bryan Health podcast. For more information please visit www.bryanhealth.org, that’s www.bryanhealth.org. This is Melanie Cole. Thanks so much for listening.
Don’t Wait Until it’s Too Late: It’s Important to Make Your Medical Wishes Known
Melanie Cole (Host): What kind of medical care would you want if you were too ill or too hurt to express your wishes? Here to tell us how you can go about doing that is Dennis Smith. He’s the Pastoral Care supervisor at Bryan Health. Dennis tell us a little bit about Advanced Care Planning. What is it? And what’s an advanced healthcare directive?
Dennis Smith (Guest): Well an actual healthcare directive is an umbrella term for numbers of healthcare decisions that can be made in advance of an actual healthcare need. These decisions can range from the decision of who one will designate to make healthcare decisions when they are unable to make them. We call that a person that is a healthcare power of attorney. Other examples of directives people can make are how to handle if they have become in a persistent vegetative state, a severe brain injury that cannot be recovered from. Many people would then give directions to their POA to withhold or withdraw life support that is only prolonging their natural dying. Another directive would be whether to be resuscitated if they should have an arrest.
Melanie: So, you are mentioning a lot of issues that come up and people hear these terms Dennis Living Will, Medical Power of Attorney and you just spoke about advanced directives and even physician order for life sustaining treatment. Tell us, what is the difference between some of these terms?
Dennis: Sure. The difference between an advanced healthcare directive and a living will, for me the big difference is that a living will is not identifying a person to serve as a decider for them if they become incapacitated. It just states that the person’s wishes. So, the powers that be at that moment of need, at least have a sense of their wishes. Advanced healthcare directives are more expanded. It can contain living will elements and also allow for the naming of power of attorneys for healthcare.
Melanie: So, what are some of the decisions that could come up and how do people begin that thought process and that discussion with their loved ones?
Dennis: Well, one of the things first off, you know why to have that paper. To not have paperwork on file leaves one vulnerable to get medical care that they may not have wanted. It also may leave one having strangers to make important decisions for them versus having trusted and informed loved ones. On any given day, people travelling on our main highway here in Lincoln, they travel without a spare, ready to go and all the jack tools that are needed. But they may have a successful journey to their destination and not have needed it, but they are gambling and not planning for contingencies. Instead of anxiety, their journey could have been able to have more with a peace of mind as they journeyed if only they had been prepared. And that’s why it’s important to have an advanced healthcare directive. But there are numbers of reasons to have those.
Melanie: So, then how do you start that conversation and what information should be included in that advanced directive?
Dennis: Well, ask yourself the question first. What’s the likelihood that one day I will have a health crisis or likely die? Once settle about that eventuality, begin to plan for it and to put one’s house in order. You seek informed consent. You then speak to people in the know that can give accurate information and to present well the benefits and the risks to one’s choices. This can include medical, legal and spiritual professionals and as you become informed, let your loved ones in on what your thoughts and perspectives are, seeking their input. It’s not uncommon for a family to not see everything the same way. Can you imagine that, a family not seeing everything together? Well, ultimately, you are the one that will sign the document and you will make the final say on what you are wanting.
Melanie: One of the big considerations is choosing that medical power of attorney. How do you select your healthcare agent from the family members, or spiritual care advisers, or lawyers or how do you pick the person that’s going to make these decisions for you should you not be able to make them for yourself?
Dennis: To me the characteristics of a good healthcare power of attorney is someone who is going to be trustworthy. They will carry out what you want. They are a vertebra, they call it, someone who has a backbone. I’ve seen many numbers of times that people choose someone other than their spouse because they believe another person would be more apt to carry out what they are wanting. And also, another characteristic is for someone to be medical savvy. They are able to receive well, information from staff and to communicate clearly and accurately to other stakeholders who have a need to know. They can hear input from others and yet ultimately, make what they believe to be loving choices that align with the person’s values and best interests. It’s convenient if that person is local and able to be on scene, however in our age of technology; a person can work from distances and still do an effective job. The person identified as power of attorney has a stronger say than even kinship. A married spouse is actually equipped even better when identified also as power of attorney.
Melanie: After you set up your advanced directives, where do you keep it?
Dennis: Well, a big thing that I like to recommend to people is for one, you want to keep it in the medical record. You would like to get that there and established because there it is easily faxed and retrieved to give to other facilities with a need to know reason. I like to recommend too that people go ahead and put them on their refrigerator. I also too, would recommend to have one in a glovebox of a car, to have one handy when on a trip. Get them into the hands of people that are important to them. Let them know where the important paper file would be and where these things would be kept so they are easily retrieved. We have had numbers of times that we could have used that information quickly and because it wasn’t made available to the family; it delayed the kind of care that these people should have and could have gotten.
Melanie: Dennis where can people fill out their advanced directives? Can they do that at the hospital? How would they go about that?
Dennis: At Bryan here, there are a number of ways that this can be done. One can be done through the health information people, pastoral care department is identified as a go to place to seek out that. So, when they come to the hospital, they would be able to ask for a chaplain and see if there is one available at that time to do that. The preferred method would be to go ahead and to make an appointment with someone in pastoral care and set up a place to rendezvous and to be able to complete that. Other thing to consider would be too to seek out legal counsel. If they have a lawyer that they trust and would like to set up something in advance that may encompass many other interests for the family; that’s another good route to go too. There are many websites such as Five Wishes and other places that have great documents to be able to consider and see if that would best suit what their needs are at the time.
Melanie: Then as you wrap up with us, share the importance of advanced healthcare decision making within the community and what else you would like the listeners to know about the importance of advanced directives.
Dennis: Well again, to be able to have that paperwork on file leaves one more confident that what they want is actually going to happen. And what happens if someone doesn’t have one? Well, I like to first mention that those who have one on record may get the amount and the type of care that they were wanting. They also may have the people contacted quickly that they would have wanted to have known more promptly because we have phone numbers to access. Those who are not equipped, may have strangers making the healthcare decisions for them, decisions that may not reflect the person’s values and their wishes.
If it’s true that the last three weeks of a person’s life can be some of the most costly; we find that many people are put through procedures and care that they would have never wanted. But they never made their wishes known and so for a family or a business, this could possibly cripple them economically due to that kind of care that they may not have wanted. And then there’s family power grabs that go on when there is not a clearly identified go to person. In the heat of battle, it’s not the time for this determination to be made. A patient’s recovery is hampered by the tension and the bickering that they feel and experience. I think a great free Christmas gift for the family this year could be a clearly stated advanced healthcare directive. You need to remember, it’s valuable, but it is free. We are blessed also that we can have freedom to express our wishes for the type of healthcare we do or do not wish to receive.
I think getting one’s house in order relieves anxiety, stress and chaos not to mention overwhelming expense and emotional turmoil and anguish that could have been avoided. Dying with dignity and the way you want it is not a bad thing. It is in fact, a very good thing. Review and update. Do so every couple of years or sooner if desired. Very mobile society. Addresses change regularly, and accurate phone numbers work best. Children suddenly become of age and then be considered as POAs. One perspective can change with further information and physical changes and so sometimes people become open to DNR when they wouldn’t have before because of a new diagnosis. So, keep updating. And then once in that medical record, it’s easily faxed and retrieved to give other facilities with need to know reason. And also, get it done. Don’t procrastinate. Many say to me I didn’t realize it was so easy. I would have done it sooner if I had known. I fretted for no reason and I’m so relieved to have it done now.
Melanie: Wow, great information Dennis. Thank you so much for coming on and explaining to everybody the importance of filling out their advanced directive and choosing a medical power of attorney because it is so important. Thank you again for being with us today. This is Bryan Health podcast. For more information please visit www.bryanhealth.org, that’s www.bryanhealth.org. This is Melanie Cole. Thanks so much for listening.