In my book; Dying Made Easy(er); Creating Your Happy Ending, the first chapter is “Estate Planning and Advance Healthcare Directives”. Placing this chapter at the beginning of the book was for a very good reason. It was important for me to start with this subject because I understood that without planning, many people experience end of life in ways not desirable to them. Without exaggeration, I have been present at end of life many hundreds of times. Like the movie title, I’ve seen the good, the bad and the ugly. What I learned was this; a good dying experience seldom occurs by good luck, and bad and/or ugly most often happen when there is a lack of forethought.
Thinking about end of life generally does not cause us joy, and in fact, most often brings up sadness and fear. Throughout my book, I discuss the subject of fear and how it prevents many of us from thinking about and planning our end of life. If for no other reason, reading the book can help with this.
Another reason people say they have not begun planning for end of life is because of the expense. Creating a will and trust with the help of an attorney will likely cost hundreds or maybe thousands of dollars, which may mean planning for the cost. There are also options for online “do it yourself” estate planning, which may save money. The easiest way to find information about these organizations is by doing an internet search.
Although there may be expenses to creating a will and trust, the good news is that planning for healthcare at end of life is free of cost, with few exceptions!
I will discuss three legal documents that can be very helpful in making choices about the medical care you would wish to receive at end of life. And perhaps equally important, what medical care you would not wish to receive.
Let’s start with the document referred to as a DNR (Do Not Resuscitate) form. This document is intended for those who do not wish to receive CPR (cardiopulmonary resuscitation). There is only one choice made with your signature (or that of your legally recognized healthcare decision maker), but because it is a legal document and a medical order, the form requires a physician’s signature also. Each state has their own form and guidelines, so I recommend that the reader check the government website for their state. This form is generally useful for the person who, because of poor health, would choose to not survive a life threatening event.
POLST (Physicians Order for Life Sustaining Treatment) is the next document we will discuss. Again, each state has their own version, so check with your specific state government website. This form allows for three healthcare choices at end of life including CPR, level of medical intervention (full, selective or comfort-focused treatment) and artificially administered nutrition. This document may be helpful for a person who suffers from poor health or has a life threatening or terminal health condition. Because this is a legal document and a physician’s order, a signature from a medical doctor, nurse practitioner, or physician’s assistant is required.
The last document discussed here is the Advance Healthcare Directive (AHCD). This document goes into much more detail than the previous forms and unlike the DNR and POLST, is recommended for every adult person, regardless of health conditions. The reason for this is because things change in life. In fact, change is about the only thing we can all count on. So there is a possibility that the young and healthy can find themselves at end of life too. The AHCD allows for specific choices to be made ahead of time and also allows for designating a medical decision maker for you, should you become unable to choose for yourself. There is also an opportunity to donate your body for research or donate organs that may sustain or improve life for another, and a decision may be made about performing an autopsy. There are some great AHCD forms obtainable on the web, but my favorite is found at www.CompassionandChoices.org. There you will find information and tools to help you make good choices for end of life medical care.
So you may be asking where the “free” part begins. I am happy to inform you that all these forms are free of charge. The DNR and POLST may be obtained from your medical doctor, and with the MediCare benefit of a doctors visit to plan for end of life, this visit is free for many people. The AHCD is not a medical document and does not require a physician’s signature, so it is free of cost for everyone. The form must be notarized (which may not be free of charge) or signed by two uninterested parties.
Please reach out to me should you have any questions and happy planning!
