A week before her mother passed away, Mary Kay Audd and her father got out her mother’s living will and reread it. Her mom, who suffered from dementia, had been transferred from the nursing home to the hospital, where she refused to eat or drink.
Doctors told Audd they could use feeding tubes to give her mother nutrition and hydration — and most likely have to go through the same routine every few weeks. Or, they could follow her wishes, and let her die naturally.
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“We knew she’d never want that (artificial sustenance),” Audd said.
And reviewing her living will confirmed it, she said.
Audd’s father died 11 months later of recurring cancer that he opted not to treat. Like his wife, he too had a living will. They both also had prearranged funerals.
The living wills, and funeral planning, made her parents’ transitions from life to death so much smoother for her and her two brothers, Audd, 54 said.
“They were invaluable … a blessing,” she said.
Experts recommend anyone 18 or older have a living will, also called an “advance directive for health care.”
The legal document, which is available for free through hospitals and on the Web, spells out exactly what someone wants or doesn’t want, if faced with a possible end-of-life decision.
People need to understand that if they don’t have a living will addressing such decisions, the state will make those decisions for them,” said Annette Prince, director of Oklahoma Palliative Care Resource Center.
“They mistakenly think saying to their spouse or children ‘Don’t ever let what happened to Aunt Bess happen to me,’ takes care of it,” Prince said. But without an advance directive, she said, state law presumes everyone — regardless of prognosis, unnecessary expense or their family’s wishes — wants all possible life-sustaining treatments, including ventilators, feeding tubes and catheters.
A living will is executed only when two doctors certify in writing that a person is persistently unconscious, or expected to die within six months. Prince recommends naming a healthcare proxy or proxies on the living will to help make decisions.
As of 2006, proxies in Oklahoma can make more than just life-sustaining decisions. If people are so disabled they cannot decide for themselves, their proxies can make other medical care decisions, including signing do-not-resuscitate consents.
Living wills aren’t just for older people or terminally ill people, said Laura Cross, Oklahoma City healthcare attorney.
“Some of the hardest cases are young people involved in car wrecks, who haven’t made their wishes known,” she said.
Educating healthcare providers and consumers about living wills has been a campaign of Cross, 63, for the past 27 years. Her passion for the cause only intensified four years ago when she was diagnosed with ovarian cancer.
Cross has found many people don’t sign living wills because they incorrectly believe the document limits their healthcare choices.
“But the document has no force and effect until you can’t make your own decisions,” she said.
For example, Cross’ advance directive specifies she wants no administration of artificial nutrition or hydration. Yet, she’s currently being fed intravenously.
“Most people can make their own healthcare decisions until their last day or so,” Cross said, “even people with terminal cancer.”
Living Wills
-Experts recommend anyone 18 and older sign an “advance directive for health care,” also called a living will. The form states the limits, if any, you want to set on medical care if you are terminally ill or unable to function without assistance, and includes a section on organ donation. It also lets you authorize a person(s) to make other medical care decisions for you, in case you become so ill that you cannot do so yourself. Decisions can include signing a do-not-resuscitate consent on your behalf, if your heart or lungs stop working.
-The legal document is free and is available at http://okpalliative.nursing.ouhsc.edu/oklaw.htm. It also can be obtained from hospitals and aging agencies. It requires two adult witnesses who aren’t heirs or relatives.
-Give copies to your loved ones, your attorney and your doctor, and make sure they can carry out your wishes.
SOURCES: Oklahoma Palliative Care Resource Center, Access Financial Resources, Oklahoma City healthcare attorney Laura Cross.
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