Understanding Advance Directives

No matter how hard we try to envision the future, advance directives and living wills don't cover every situation. In theory, these documents are meant to ensure clear-headed decision-making about emotional decisions regarding end-of-life care. Kathy Glasmire, Associate Director of Sacramento Healthcare Decisions, warns that, "the advance directive documents tend to focus on a procedure or a treatment, rather than on what the goal is at the other side of the treatment." In other words, the forms themselves cannot replace the heartrending decisions that families have to make but they can provide an opportunity to begin an end-of-life care conversation for you and your family.

Glasmire also suggests that having this discussion in advance encourages the notion that a family is comfortable with the decision they've made, that they can be caring and well-informed advocates for their loved ones.

Terms

Advance Directive
Written instructions specifying the type of future medical treatment to be used in the event you become unable to speak for yourself. Advance Directives are state-specific and fall into two categories: Living Will and Durable Power of Attorney.

Caregiver
A person who provides care for the elderly and/or ill so that they may remain in the home. It is estimated that 80 percent of at-home care received by older Americans is provided by family members - spouses, children, grandchildren and other relatives.

Durable Power of Attorney for Health Care
A document that grants another the power to make decisions concerning medical care in the event you cannot make those decisions yourself. Also called a "health care proxy", the appointed person is authorized to speak for you any time you are unable to make your own medical decisions.

Hospice Care
An individualized program of support for people within the final stages of a terminal illness and their families. Hospice care may take place in the patient’s home or in a hospice facility. The emotional, psychological, and spiritual care also includes the family that continues to receive ongoing support even after the patient dies. In 1999 almost one-half million Americans took advantage of this special service.

Living Will
Written instructions specifying the type of medical care to be used at the end-of-life once the patient is incapacitated.

Palliative Care
Care which focuses on providing comfort and relief from suffering with the goal of ensuring the highest quality of life for the terminally ill. Also called "comfort care", palliative care helps the dying person remain at home and a functioning part of the family. Palliative care may also include support for the patient’s mental health and spiritual needs.

Sources: Partnership for Caring: America’s Voices for the Dying™, Zen Hospice Project, Growth House, Inc., Caregiver Network.