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How to get your Senior Adult the health care they desire?

There are two ways to assure that the health care desires of your Senior Adult are met. The first way is a Living Will, the second a Health Care Directive. Both of these are legal documents that allow your Senior Adult to specify how they want to be taken care of in the event they cannot make those desires known in an emergency.

This is probably one of the most difficult conversations that you will ever have to approach but it is by far one of the most important. A Living Will or Health Care Directive will take you, step by step, through the issues to be dealt with, but here’s an idea of what you will need to discuss.

  1. It is very important to designate a Health Care Representative. This is a person, probably spouse, or in the absence of spouse, a child or children, or close relative that the Senior Adult clearly specifies that they want to speak on their behalf if they cannot speak for themselves. The desires of the Senior Adult should not only be communicated to this representative, but it must also be determined if the representative can and will carry out the Senior Adults’ wishes. Also all family and friends that this directive will impact should be informed of the Senior Adults desire.
  2. After determining the representative the Senior Adult then needs to inform the representative of their desires regarding ongoing care. The Health Care Directive or Living Will form will lead you through a series of questions that pertain to the Senior Adults long-term care. Some of the questions that will need to be decided are:
    1. Life Support. What is being asked in this question is how much help does the Senior Adult want in sustaining life: respirator, dialysis, feeding tube, etc. It is very important that this is the Senior Adult’s desire and choice. If your Senior Adult says,"No life support, if I die, I die," even if you personally disagree with this, you must represent their wishes as the designated Health Care Representative.
    2. The Senior Adult will need to make the same decisions as mentioned above but in a different scenario. For example if the Senior Adult is close to death. Close to Death being understood to mean that life support would only prolong the moment of death. What does the Senior Adult want you, as their representative, to do to prolong their life and for how long?
    3. Next the same questions as above are asked but the Senior Adult condition is different, one of Permanent Unconsciousness. Permanent Unconsciousness is understood to mean that the likelihood of the person ever returning to a conscious state is very unlikely.
    4. Another condition to consider is Advanced Progressive Illness. Progressive illness is defined as an illness that will be fatal and is in the last or advanced stages. Further conditions are that the Senior Adult is unable to communicate by any means, cannot swallow food or water safely, cannot care for themselves or recognize family and or friends and their condition is unlikely to improve. If you live in the state of Oregon you should also address the issue of assisted suicide.
    5. Yet another situation is Extraordinary Suffering. In this situation one must decide if life support measures to help the Senior’s condition would in fact only cause additional suffering and permanent pain.

This document when completed will need to be certified as legal. (Certain states require the document signatures to be notarized.) A lawyer can be retained or information is available online to verify your states’ requirements. This document should be stored in several places: Lawyers office, safety deposit box, retained by the designated representative and several copies, by the Senior Adult. There are very few places a Senior Adult can go where they will not be asked to show proof of a document of this kind. This document must also be reverified every seven years as the ongoing wishes of the Senior Adult.

Once again, while this can be a difficult and uncomfortable discussion, the result will be that the Senior Adult will be cared for in a manner that they desire and no one will be put into the situation of having to make life changing decisions without knowing what the Senior Adult desired. Also as the Senior Adults Health Care Representative if you are being asked to make decisions that may terminate someone’s life, it is easier to deal with that now, while there is still good communication with the Senior Adult, than to deal with this decision under emotional duress.

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