caring for elderly parents
Advance Medical Directives
An Advance Medical Directive provides guidance to medical professionals if you are incapacitated and cannot make your own medical decisions. Currently, there are two primary documents which fall into this category: Living Wills and Durable Power of Attorney for Health Care Decisions (DPAHCD). The DPAHCD is preferred for the following reasons:
Living Will
- A vague statement saying a physician may withhold or withdraw treatment if you are terminally ill.
- A piece of paper that medical professionals may ignore or misinterpret.
- Gives blanket authority to a doctor you may or may not know, a serious concern in these days of managed care.
- Generally exempts doctors from liability, regardless of medical surrogate"s directions.
- Does not guarantee your wishes will be carried out.
- Presumes non-treatment, regardless of medical situation.
- Allows "treatment" to be defined by state law. (In many states, assisted nutrition and hydration are considered medical treatment).
DPAHCD
- Appoints a surrogate to make your medical decisions (applies in any crisis, regardless of prognosis).
- Names a person who will be your advocate.
- Gives authority to a loved one who knows your wishes.
- Legally clarifies surrogate.
- Generally exempts doctors from liability if following decisions.
- May include an addendum outlining your specific wishes to hold your surrogate accountable.
- Defers to surrogate and written wishes.
Other information to consider
The Patient Self Determination Act of 1990 requires health care facilities receiving federal funds to ask patients upon admission if they have or want to sign an Advance Medical Directive. However, the time to consider and sign such a document is before you are hospitalized, ill or injured.
The existence of a medical treatment or technology does not obligate you to utilize it. There is a "time to die" and let nature take its course when medicine cannot reverse the dying process.
The first living will was devised in 1967 by members of the Euthanasia Society of America, now known as Choice in Dying.
In recent years, living wills have been increasingly used to justify the removal of life-sustaining treatment (ventilators, tube feeding, etc.) for patients who are disabled but not terminally ill.
- If you sign a DPAHCD, consider adding an addendum or letter to your surrogate outlining your wishes in specific situations. This may include when you would desire tube feeding, the use of a ventilator and CPR, as well as your views regarding the beginning, withholding and/or withdrawing of medical treatment. This may also include your wishes regarding where you want to die (hospital, nursing home, at home) and whether you want your age, physical condition, finances or other circumstances to play a role in decision-making.
- Always name a successor in case your surrogate is deceased or cannot be reached by medical professionals.
- Update your document on a regular basis to ensure it reflects your current wishes and desires.
- Copies of your Advance Medical Directive should be provided to your family, physician and local hospital.
No document can replace open and honest communication with your family and friends before a time of crisis.
Background Information
Hospice: Offering Quality of Life to the End of Life
Approximately 30 years ago, a U.S. volunteer movement began that would revolutionize health care.
Aging or Alzheimer's
Regular signs of growing older often get paralleled with Alzheimer's. Find out the difference.
Caregiving Support Systems
Providing for an aging parent can be stressful. It's important to be surrounded by others who can help.
Help From Hospice
For terminally ill patients, hospice is often a welcomed care option.
Is It Alzheimer's?
If you're concerned about your loved one's mental health, here's help distinguishing normal memory loss from the onset of Alzheimer's disease.
Questions and Answers
How can we show concern and respect for the elderly?
Answer
Review Frequently Asked Questions
Stories
Making My Mother's End-of-Life Decision
If Mom lived, would she want to be a "vegetable" the rest of her life? What if she never came out of her coma? What would she want us to end her life?
Full Circle
From child to parent, one woman reflects on caring for her mother.
The Long Goodbye
A daughter faces the harsh reality of her mother's Alzheimer's disease and the difficulty of loving the stranger her mother has become.
You Can Go Home Again
As parents reach their later years, many children feel the tug to move closer to them.
If you've been through a experience related to this topic, we invite you to share your story with others.Share Your Story
Other Things to Consider
Loneliness and Depression Afflicting the Elderly
If you know an elderly person who you suspect is clinically depressed, don't brush it off. Do whatever is necessary to get them the help they need.
If I End Up Like Terri: An Open Letter to My Wife
Teri Schiavo's tragic death made many people think. One man reflected on his future with his wife
Where is God in the Midst of All My Troubles?
So many cry out to Him in times of need, but is God really listening? And, more important, does He care?
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