Living with cancer blog

Planning ahead with an advance directive is crucial

By Sheryl M. Ness, R.N. February 26, 2014

Planning ahead with an advance directive is important for everyone, since accidents and serious illness can strike at any time. It may be even more important to you now as you're dealing with a life-changing diagnosis such as cancer.

The primary purpose of an advance directive is to outline the medical treatment you'd want (or not want) as well as naming the person you'd like to make healthcare decisions for you if you're no longer able to express your wishes.

It's important for you and others to understand and protect your wishes by putting them in writing. It can be overwhelming to understand where to start and how to plan your advance directives.

As part of this plan, you can name someone to make medical decisions for you — this is called a medical or health care (or durable) power of attorney. This person can assist in making medical decisions for you (based on your wishes) when you're no longer able to speak for yourself.

A living will is a document that allows you to outline in writing which medical treatment you want or don't want at the end of your life. A living will takes effect only when you're at the end of your life and are no longer able to express your wishes yourself.

A living will often applies only when you're suffering from a terminal or irreversible condition and aren't expected to survive without further medical treatment. Many times, a durable power of attorney and a living will are combined in one document.

If you have not thought about an advance directive, you may want to start by thinking about what's important to you in your life. You may want to consider the following questions:

  • What makes you happy to be alive?
  • What limitations or conditions would make your life no longer meaningful to you?
  • What is most important about your quality of life?
  • What are your beliefs?
  • What do you value the most?

Remember that it's also important to understand which care you can choose or refuse. Medical treatment at end-of-life is usually one of three types: life supporting, life sustaining and life enhancing.

  • Life supporting treatment uses such treatments as CPR, respirators and medications that are meant to keep you alive or resuscitate you if your heart or breathing stops.
  • Life sustaining care may include such things as tube feedings or giving fluids through your veins if you can't eat or drink.
  • Life enhancing care is meant to keep you comfortable until death occurs naturally. Nothing artificial is done to prolong your life. This is frequently provided through hospice care and may include pain medications, fluids, comfort care and oxygen.

You may also want to discuss a Do Not Resuscitate (DNR) order which indicates that you don't want to have CPR if your heart stops while you are a patient in either a hospital or care center.

It's important that you talk with your family and your care team about your wishes. Remember that everyone has different beliefs and wishes. Your personal wishes are the ones that matter the most as you're planning for your advance directive.

Have you made a plan to outline your advance directives? Please share your thoughts on this topic.

With

Sheryl M. Ness, R.N.

Follow on Twitter: @SherylNess1

Feb. 26, 2014