Plan your life…all the way to the end
Tina Soares recalls how her 84-year-old father, who had end-stage Parkinson’s disease and another underlying condition, tried to help his home health aide by vacuuming. Without the aid of his walker, he fell and was taken to the hospital with a head wound.
Because Soares, a registered nurse, had already had previous discussions with him regarding what medical measures he did or did not want done to possibly extend or save his life, her father was stitched up and sent home. He died 72 hours later, she said.
“Our goal was to get (him) home and be comfortable,” she said.
Without having had these conversations, Soares said, her father likely would have extensive testing and been admitted to the hospital for more treatment than he would have wanted. Although he was able to speak for himself, in an acute or emergent situation, it can be confusing and stressful for patients and their families.
Soares, who works for the Visiting Nurse Association of Cape Cod, leads a community effort known as the Quality of Life Management Task Force, which encourages Cape Codders to designate a healthcare agent, someone who is legally empowered to act on another’s behalf to make medical decisions when that person is unconscious, has dementia or is otherwise unable to make their own choices.
The task force has been meeting for more than a year, and its 73 members represent a broad swath of the Cape community, such as Cape Cod Healthcare, estate planners, assisted living facilities, private healthcare agencies, religious leaders and nonprofit social organizations. It draws upon the public education effort of the non-profit, Honoring Choices Massachusetts, and The Conversation Project for information about planning ahead and starting the conversations.
Spreading The Word
Task force members are charged with spreading the planning message to their respective organizations and groups. Soares credits Cape Cod Healthcare Chief Medical Officer Donald Guadagnoli, MD, with starting and championing the initiative.
Naming an agent on the healthcare proxy advance directive can be done by completing and signing a simple one-page form in the presence of two witnesses, who also sign it. A copy of the document should be given to the proxy, who should be told what decisions the individual would like done and under what circumstances, Soares said.
These wishes may be spelled out in another document known as a living will or personal directive, which is not legally binding in Massachusetts but can help guide the proxy when making decisions. A copy of these documents should also be given to and discussed with the individual’s physician, she added.
Cape Cod Healthcare will be offering a package of information, including a healthcare proxy form and a personal directive document and instructions, on its website https://www.capecodhealth.org/quality-of-life during the week of April 16-23, in honor of National Healthcare Decisions Day, Soares said. Related information and forms can also be obtained at the Honoring Choices Massachusetts website via its Who’s Your Agent? program.