It's something no one wants to talk about, but doctors say everyone should have an advance healthcare directive. Talking about it doesn't have to be difficult or stressful. Knowing the facts and following a few tips can make the conversation go smoothly for everyone, especially when speaking with an elderly parent or relative.
New research shows that roughly 50 percent of people over age 65 who are admitted to the hospital because of illness have trouble making healthcare decisions. "That's a good warning sign to all of us, especially if we have relatives approaching the age of 65," says Anna Beck, MD, the Huntsman Cancer Institute. When that happens, says Beck, say if a patient can't hear or she's experiencing confusion or dementia, doctors ask a healthcare proxy with power of attorney to step in and help make decisions. This person can be a friend, family member, or attorney.
An advance directive is a way to tell your family and doctor your wishes if you can't make decisions yourself. It's important to make these wishes known while you're healthy and before a crisis. Advance directives don't limit the quality of care, just the types of treatments you choose. There are three types: living wills, POLST forms (doctors' orders that transfer between treatment facilities), and Do Not Resuscitate (DNR) or Do Not Intubate (DNI) orders.
Approaching the topic with an aging parent can feel uncomfortable, but Beck says it's vitally important. She recommends putting a time limit on it to ease everyone's nerves. "Let's just spend ten minutes on this, Dad, so I don't have to be stressed and I'll know what's important to you," she says.
It's also helpful to look at the big picture, quality of life issues, like being able to play with the grandkids and going to the bathroom without assistance. "You may be surprised by how un-stressful that conversation can be. They are generally thinking about it, and sometimes just being able to share their thoughts will help them feel better about it, too."
A doctor, nurse, or social worker can help you get started, or the forms are available to download online. It isn't necessary to hire a lawyer when doing advance directives, though an attorney can be helpful in explaining terms and procedures. It's a good idea to review and update your directives every year, and you can change your directives any time you like. Your directives only take effect if you can't speak for yourself.
Talking to your parents, and planning for yourself as well can provide great peace of mind for the whole family. We plan ahead for our businesses, our homes and belongings, and doctors say we should plan for our healthcare as well.
"It's a triad—it's the patient, the proxy, and the doctor," says Beck.
For help filling out advance directives visit fivewishes@agingwithdignity.org and .