The time to talk about end-of-life care is before we need it, when we can consider alternatives calmly and discuss them with our doctors and family. We may want to go through the exercise more than once as we age and different health conditions and ways to treat them emerge. One study found that among people who had at least two chronic conditions (COPD, heart disease, diabetes, arthritis, Parkinson’s, etc.), 82% of those with physical challenges and 83% of those with mental challenges opted for more medical treatment, not less, when they revisited their end-of-life care decisions after two years.
Beginning in 2016, Medicare will reimburse your physician for an appointment made to discuss what kind of care you would like if you become unable to make decisions later: $86 for the initial and $75 for any follow up meetings. Your family physician may not know this.
The Texas State legislature has created not only a Medical Power of Attorney, which lets you designate someone to speak for you when you cannot, but also an Advance Directive to Physicians. The Advance Directive to Physicians tells your doctors what you want if you are found to be in a permanent vegetative state or so ill that even with medical treatment you are not expected to live more than six months. It also has space for you to specify what you want in what circumstances.
In addition to WebMD1, Death with Dignity2 and Five Wishes3, today there are many videos on end of life discussions and how to talk about this with your family and your doctor. You can get an idea of what the more common approaches are (CPR, intubation, ventilation, artificial feeding and hydration) and even order brochures from the website of Compassionate Care of California.
Curiously, on average, people who opt for hospice with its support and palliative care actually live longer than those who do not.
3 https://fivewishes.org Please note that the documents included are not valid in Texas.
Estate Planning attorney, Terry Garrett, is a member of the National Academy of Elder Law Attorneys and is active in the Texas and Austin Bar Associations. She graduated with honors from Cornell University. She was on the Dean’s List at Wharton Business School. She earned her J.D. at Columbia Law School, receiving the Parker Award and a Mellon Fellowship.
She assists families of people with special needs, people planning for the retirement years and people administering estates.