Caregivers are often faced with difficult decisions regarding the long-term health care of loved ones. Living wills are a great way to help ease this burden.
As a caregiver, health care decision-making with the loved one for which you’re providing care is a sensitive subject to broach. As vitally important as this planning can be for caregivers, they may feel overwhelmed when thinking about making important decisions for another’s health care.
However, involving your loved one in these decisions prior to a significant medical event can help diminish this burden. Educating and informing yourself on the issues makes this often misunderstood topic easier to handle; understanding advance directives, specifically living wills, is a valuable first step.
An advance directive is a set of instructions a person gives that outlines their health decisions in the event they are unable to make those choices. It is important when providing care for someone to understand what their wishes are and to be able to honor them when possible. One type of advance directive is a living will, which is a legal document that contains an individual’s wishes for life-prolonging treatments. Before preparing a living will, the following broad details should be addressed:
- The laws regarding living wills vary state to state
- A living will does not go into effect until the individual is incapacitated and unable to make decisions; oftentimes, a physician will make this determination
- The physician for the loved one you are providing care for should be aware of the living will and what that person has decided
Components of a living will can be very specific in regards to medical treatments. It is a good idea to discuss these with both the individual and their physician. Some specific medical treatments to consider when discussing health care decisions include:
- Pain relief and how it will be managed
- Antibiotics as treatment for infections
- Artificial feeding (feeding tubes)
- Cardio pulmonary resuscitation (CPR)
- Ventilators (breathing machines)
While not required, consultation with an attorney can be a good start to this process. In addition, organizations such as the American Hospital Association (AHA) make available key educational resources to provide basic information on getting started with living wills and urge those receiving care to express their preferences in writing. The National Hospice and Palliative Care Organization website also provides state-specific forms.
Although broaching the topic of a living will may be a difficult conversation to have, it is essential as a caregiver to ensure that health care providers and family members are aware of the loved ones desires related to medical decisions. Having this conversation may alleviate some stress in your caregiver relationship and provide peace of mind to you and your family that their wishes will be honored.
Michele Mongillo, RN, MSN, is a clinical director who has over 20 years of nursing experience in a variety of settings including acute care, head/spinal cord injury rehabilitation and long-term care.