End-of-Life Care: Who Will Speak for You?
No one wants to consider their own mortality. Eventually, though, it’s something we all must face, so it’s best to make some hard decisions now, to guide our loved ones and healthcare providers about what we want at the end of life.
Today is National Healthcare Decisions Day, which hopes to encourage everyone to put their end-of-life wishes in writing. It’s also a day to remind healthcare providers – doctors, hospitals and care facilities – to respect those wishes, whatever they may be.
All too often, though, most people’s wishes go unexpressed. Various studies show that only about a quarter of all adults have prepared advance directives.
Don’t be intimidated, though. Advance directives can be created without a lawyer, for free, and relatively easily. They come in two main forms:
- Healthcare Power of Attorneys (HCPoA) identify the person (sometimes called a “proxy,” “agent” or “surrogate”) you choose to speak on your behalf if you cannot speak for yourself.
- Living will delineates which medical treatments you would or would not want at the end of life.
While preparing advance directives, it’s important to include your caregivers. Unfortunately, most don’t. The U.S. Agency for Healthcare Research and Quality found that just 12 percent of patients with an advance directive had received input from their physician.
Even among patients who have an advanced directive, most doctors – 65 to 76 percent – say they were not aware that it existed. This can be remedied by including the directive in the patients’ electronic medical record, although less than 50 percent of the severely or terminally ill patients had a directive in their medical records.
That’s why Cleveland Clinic and many other healthcare providers nationwide are taking part in today’s National Healthcare Decisions Day.
To increase awareness and decrease the stigma associated with Healthcare Power of Attorneys (HCPoA), we are encouraging all of our caregivers to complete an HCPoA or bring in their already-completed HCPoA to be scanned into their electronic medical record.
We’d like patients to do the same. For those who already have an advance directive, take it with you to your medical appointments and make sure it is are part of your medical record.* For those who still need to fill out directives, we offer the proper forms, links and Q&As on our website.
This may not be something we want to talk about, but it’s certainly something we need to talk about.
*Cleveland Clinic patients can add their directives to their medical records by faxing the forms to Cleveland Clinic’s Advance Directive Coordinator at 216-444-9050 (To confirm receipt of fax, call 216-444-0655.) or mail the forms to Cleveland Clinic Advance Directive Coordinator, Care Management, Desk P87, 9500 Euclid Ave., Cleveland, OH 44195-9905.
Design | Creativity Life Coaching
8yPrior to working in an ICU, I never really considered all the challenges that face families, especially when end-of-life considerations and choices have never been addressed or made. The emotional and psychosocial burden that is placed on family members is immense. Experiencing this first-hand, I am huge proponent for all family members defining their wishes as well as establishing a clear POA.
Remote EAP Counsellor at Care first
9yI didn't know that about a DNR form. That unless it is filled out by the doctor it can go ignored. If people are making that choice could they not receive therapy as well. That won't talk them out of making those choices but give them the power and strength to know that the choices they make for themselves are the right choices as well.
Ships. Inspection at quarantine
9ynice meeting you, more blessing
RN Clinical Care Coach at CircleLink Health
9yAn Advanced Care Directive is a must. However, it does not help when the person is at home and his or her wishes are in black and white on the Directive and HCP form. In New York, there must be a DNR form in the home or the Directive and HCP are worthless. Little did my mother or I know this. It is very sad to think that you made the right decision and filled out the correct forms that provided everyone with your wishes and then it is ignored and CPR, intubation, transfer to the hospital continues to be carried out because the DNR form was never made by the doctor.
Certified Detention Officer at TCSO and LPN
9ymy feelings exactly Vickie. working as a nurse for over 25 years it's strange to look and see all the changes and attitudes toward to health care in general but mostly over the patients choice, and rights. as nurses we have to help do the best we can , and at the patients request , that may be comfort measures only . not every case is heroic measures, but the patient should be able to make that choice and that decision right there , no matter what they choose is heroic enough for me.