Advanced Directives

There’s no escaping one central reality in life: the fact that one day, our lives, as well as the lives of our loved ones, will come to an end.

While there’s nothing pleasant about dwelling on that eventuality, it is incumbent upon all of us to make sure that our “end of life” wishes are known and honored.

At the Northwest Georgia Healthcare Partnership, we stand ready to help anyone in our service area navigate through the process of creating these “advanced directives,” or written guidelines that outline what type of care one wishes to receive if and/or when one becomes critically ill.

This is important for several reasons. For one, many people facing the end of life are not physically or mentally able to make important decisions about their care. That leaves the responsibility to their loved ones to decide whether or not to place them on life support, employ a respirator, increase or decrease pain medications, and many other very personal decisions.

Another reason is that many critically ill patients are receiving hospital care, being treated by physicians who may not know them well and may not be aware of their preferences in this area. And so those physicians, with all good intentions, may choose to continue life-prolonging treatments that may, or may not be, in the true interests of the patient.

What it all comes down to is that it’s up to each one of us to choose what type of care and treatment we wish to receive in our final days, weeks, or months.

And so it makes good sense to evaluate how we feel about various scenarios well before the need to make a decision arises.

In our office, we have a booklet called the Critical Conditions Planning Guide. It’s a resource that allows you to read and answer questions about any number of topics, such as whether or not you wish to donate your organs after death, whether or not you wish to receive heavy doses of pain medications or very little at all, etc.

Basically, as you work your way through the questions in this booklet, you will be able to define what you view as your ideal quality of life and see what’s really important to you with respect to end-of-life care.

And then, once you’ve made those decisions, you may record them in a document such as The Georgia Advanced Directive for Healthcare. You will need to sign this document in the presence of witnesses. Then it can be placed on file with your primary physician, your local hospital, and in the homes of your loved ones.

The Georgia Advanced Directive for Healthcare is divided into four parts. Part I deals with identifying the person who is to act as your healthcare agent. Usually that’s a family member, but it’s often a close friend, neighbor, or business associate.

Part II deals with treatment preferences. For example, some patients want to prolong life as long as possible, while others opt for allowing nature to take its course at its own pace. Some wish to be heavily sedated, while others prefer limited drug interaction. Many people have no qualms about agreeing to have a respirator inserted to aid breathing, while others prefer a DNR, do not resuscitate, code that would prohibit that.

Part III of the Georgia Advanced Directives for Healthcare provides for guardianship, which may or may not be the same individual as one’s healthcare agent. And Part IV deals with securing witnesses and signatures to make the individual’s wishes concrete and legally binding.

There’s more at stake than just putting your loved ones’ minds at ease in terms of what you wish for in your final days.

It’s also an economic decision.

Studies show that end-of-life care for persons who have made their end-of-life decisions known is $65,000 less, on average, than for those who have not. Keeping a patient alive indefinitely can create an economic burden on a family after death and on the healthcare system as well. Sometimes the expenses that are incurred are unable to be paid.

Without an advanced directive on file, some patients who might have wished to die a natural death might have their lives prolonged much longer than they would have desired by well-meaning physicians or family members.

At the NGHP, we have copies of the Critical Condition Planning Guides available in both English and Spanish for anyone who’d like one. We’re happy to walk you or your group through the process, and we can also help make sure your signed forms are on file with local healthcare providers. Just let us know if – and how – we can help.

In Good Health,

Greg Dent