November is National Hospice and Palliative Care Month. As a member of a pediatric palliative care team, my job is to help provide an extra layer of support to patients and families facing serious, or potentially life-limiting, illness.
We seek to maximize quality of life in the face of a sometimes uncertain journey and to ensure that a patient and their family’s goals and wishes are honored when making important medical decisions.
For our patients who are 18 years of age or older, it is important for us to make sure their wishes are honored as adults. Because of this, we recommend all adult patients, as well as non-patients (I’m talking to you parents and grandparents!) complete their advance directives. Let’s face it, life is unpredictable. In an era where there is so much medical technology available, the possibility of an immense family burden or poor quality of life may lead some to choose options other than life-support or aggressive resuscitative measures.
What Are Advance Directives?
Advance Directives are legal documents that give you the ability to express your wishes for medical treatment before the emotion and stress of a decision can cloud your judgment.
Advance Directives typically come in two forms:
Healthcare power of attorney (HPOA) is a document that allows you to select a person whom you trust to be your voice for healthcare decisions if you become unable to speak for yourself.
Living will is a document that describes what types of medical treatments you would or would not want at end-of-life ONLY if you are faced with a terminal condition or are in a permanently unconscious state.
Of course, if you assign a loved one to become your HPOA, we strongly encourage you sit down with them to discuss your wishes. It doesn’t have to be scary – a casual conversation over dinner may be all it takes to make sure your voice is heard!
It is important to know that these documents can be modified at any time, and while each can be completed separately, we encourage a conversation about both so that loved ones can better understand your wishes and what is important to you when it comes to medical decisions. We have even encouraged adult members of a family to sit down together over a meal to have these discussions with each other as a way to promote closeness, trust, and understanding.
The best time to do this is before an emergency arises, when everyone is of sound mind and calm demeanor.
Interested in Completing Your Advance Directive?
Each state has its own Advance Directive forms that can be filled out and notarized. State of Ohio documents can be downloaded and printed here. If you are a patient over the age of 18, we encourage you to contact your healthcare provider or social worker to get help in completing these forms.
Alice Bass, APRN, is a pediatric nurse practitioner with the advanced illness management team at Nationwide Children's Hospital. Alice received her BA from Miami University, Oxford, Ohio and her MSN from Boston College, Chestnut Hill, MA.
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