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Advanced Health Care Directive

Gerontologist Therese Johnson discusses the meaning and purpose of an Advance Health Care Directive, also known as living will.
An advanced healthcare directive is a legal document in which the senior specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of medical or mental incapacity.
Advance directives have become increasingly important because life-extending medical technology now means that 1/4 to 1/2 of deaths in the U.S. occur in a hospital. The Advanced Directive is intended to block, though “refusal of treatment”, prolonged expensive and painful treatment in the final days and hours of life.
Therese Johnson, with host Jim Chong, on her Money 105.5 FM Senior Moments radio show.

INTERVIEW TRANSCRIPT

Jim Chong: Therese Johnson of Senior Care of Sacramento. Therese how are you doing?

Therese Johnson: Hi Jim. I’m doing good, and I wanna thank you for sharing that poem, I love The Dash. I’m gonna be working on some of my dashes this week visit with two of my brothers who I’m haven’t had a chance to have much time with.

poem

Jim Chong: Wow. Well, this is great. Well, you know, I hope you get some quality time, and I’m sure you will. Now today I know we have very special topic. We’re gonna be talking about a few of the four myths related to Advanced Directive, and, basically, this is a very important thing to understand, and what we wanna do is just really understand them, because there are myths about Advanced Directives. And so I wanna turn it over to you to talk about this. Now, first off, I just want, for those of does unaware, for you to share what an Advanced Directive is.

Therese Johnson: So, basically, they’re any legal documents that will tell others what to do if something should happen to you.

Jim Chong: Okay.

Therese Johnson: And, I mean, they can be several different documents including a living will and a medical power of attorney. But you need to make sure that your wishes are carried out if you become incapacitated, and that what these documents do for you.

Jim Chong: Great. And I know about the advanced health care directives, they’re very important to get in place, especially if somebody is still little a cognitive, it is the best time to do it – to put it in place before your loved one is not really cognitive anymore. So, if you can tell us a little bit about the three of the four please.

Therese Johnson: Yeah, and, absolutely, like you said, when you’re growing older and you start considering things like nursing homes or assisted living, possibly hospice, then it’s vital that you have the proper medical advanced directive in place. The problem is there’s quite bit of confusion about advanced directives, and what they can or cannot do. And, as a result, some people had been fearful of having the documents drawn up. But one of the myths is that an Advanced Directive is not valid if the state forms aren’t filled-out, but, in actuality, the vast majority of states don’t even have forms. So that’s not something you really have to worry about. As long as you have the Advanced Directives written down and completed, then doctors are obligated to follow them. There really are no state forms to fill out to make them legally valid. So that’s one of the myths. And then the second myth is that Advanced Directives are always legally binding, and that’s not necessarily true. If a doctor determines that something would be medically inappropriate, or with go against their consciences a caregiver, then they can choose not to follow your Advanced Directive. So, basically, the Directive is designed to give your doctor protection from the family if they follow through with your wishes. So that’s the second myth and another reason why it’s so important to have them in place.

Jim Chong: And what is the third. You can’t leave as hanging to much here – at least one more and we have a few more myths.

Therese Johnson: Okay, the third myth is that treatment will only be stopped if I have a living will. And some people don’t want to continue treatment when the near end of life. So, if you’re one of these people, keep in mind that you don’t technically need a living will for this to happen. However, your family members will be the ones making decisions. That could mean dispute and stress for them, and your siblings fighting for whoever is your power of attorney or not. And so, by having a living will in place, everything will already be decided, coz you’ve already said what your wishes are.

Jim Chong: Now let me ask you this – you say that a medical professional, on the second one, that they can override the decision – is that correct? Did I hear you correct?

Therese Johnson: Yes, a doctor can, that’s true.

Jim Chong: Okay, and let me ask this – I know it’s very important to put things in the place before a situation happens, but what sort of situations have you been through where you haven’t seen the right things put in the place?

Therese Johnson: Well, for example, one family – the son had power of attorney and had the mother’s Advance Health Care Directive where she had explicitly said that she did wanna kept alive on life support, or extreme heroic measures or feeding tubes or anything like that. Well, she had a stroke and the paramedics came and they brought her back to life but, basically, her brain was dead. So they put her on a feeding tube and the son wasn’t real clear on what her wishes were. That’s another thing that’s really important, you need to make sure that the person you give power of attorney to really understands what their job is. And so she was kept alive by feeding tube but her brain was dead for a few more days, and the finally, after he realized that that was not her wish, he took her off. But, if he had understood that to begin with, the family, basically all the other brothers and sisters had watch her kind of die two times. So they wouldn’t have been put through that emotional stress and that lingering of the whole situation. It could have been resolved immediately if you’d understood her wishes.

Jim Chong: Is very important. One of things that I was talking to some other professionals, licensed in the arena of just financial services, and working with seniors is really different. You know you have to a lot more careful which is really important coz I try to really take a lot of care, make sure there’s a third party there as well to validate things And it is so easy, unfortunately, for people to take advantage of seniors, and I think getting this things in place are so very important. Even families with good intentions, I’ve seen them really go awry because the right things were not put in the place. I know there were some cases where should someone maybe be kept alive on life support or not – these different directives, that if you put them in place and you have someone’s wishes or desires in front of you, they really help. And so I encourage people. One practical I would love to give people is – if you’re getting older and even if you’re younger, write out what you would want people to remember about you. Now that is just something that when you do pass, it could just be read. And I know there’re some things that I want to remembered by. In that way, people know exactly what you want to express and what your life meant and what you wanted to convey. So I encourage you – take-out a piece of paper, write that down, and contact somebody like Therese Johnson to put some things in place in terms of potential placement, or just what your alternatives are in terms of potentially a facility or just how you should go about planning what sort of things you should look for, signs, for when you should make certain moves. Any final things you wanna share Therese before we move on.

Therese Johnson: Well, just like you said, you know I want people to make sure that they communicate their wishes really clearly so that you can ensure everything is carried out how you would like now and in the future. And I do have advanced health care directive available. If people had been putting that off, getting it done, they can email me and I’ll be happy to email them the document.

Jim Chong: Great. Well thank you so much. And how can people reach you? I believe I’ve been directing them to Senior Care of Sacramento. Is that where they can find you?

Therese Johnson: Yup, dot com, or if you wanna email me for the document, it’s seniorcareofsacramento@gmail.com

Jim Chong: Great.

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