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The Importance of Advance Directives for Older Adults

If even you or a loved one is not suffering from a chronic or life-limiting illness, no one can ever know when he or she might be in severe pain or too ill to express their wishes about the kind of medical care they want to receive. To avoid confusion or conflict among family, friends and healthcare providers, an advance directive is an important document to have.

As the name implies, this legal document directs medical providers in advance by spelling out a person’s personal desires regarding the kind of medical treatment or end-of-life care he or she wishes in the event it becomes impossible or too difficult to convey those wishes on one’s own.

A comprehensive document will spell out the types of decisions that may arise at that time, among them nutrition and hydration, use of a ventilator, CPR and defibrillators (and the “do not resuscitate” order), and the types of desired comfort care.

Creating your advance medical directive
You do not need to be dealing with a medical condition to write an advance directive–it can be created at any age and when you are healthy. For example, young couples who are newly married or starting families may create them along with their wills. Even young adults who are no longer minors should have one as a proactive and very helpful tool for physicians, nurses, and family members.

The first step in creating your advance directive is to give careful consideration to the type of treatment you would want–or not want–in the event of a medical emergency and at the end of life. A healthcare provider can outline the various possible scenarios, explain treatment options, and help you determine what is in your best interests and/or aligned with your values.

One’s personal beliefs or values, cultural or religious background, and other factors often help shape a person’s decisions about how they would want to spend time in the case of an incapacitating or a terminal illness, or in the event of a catastrophic accident. Some people may feel strongly that all medically possible interventions are the way to go; others may prefer that no “heroic measures” or other interventions are taken at all.

At the JCHC, we strongly recommend that all our residents have an advance medical directive in place; as we know, things can change in a heartbeat. If you drew one up at an earlier age and your health condition or perspective has changed, it’s a good time to update it now to reflect your current wishes. That way, your loved ones and medical providers will have a clear picture of what you want in any situation that may arise, so that you can receive (or not receive) medical treatment on your terms. Although the subject can feel sobering, the decision-making is empowering.