Take charge of your life and your death: Complete an advance directive

Monday, April 15, 2019

Imagine this scenario: a sudden event such as a car accident or illness renders you unconscious and unable to communicate.

You are receiving all the medical care necessary to survive, but your medical care team believes there is little chance you will ever recover consciousness or function independently.

Under these circumstances, what do you think should happen next? Would you want medical treatment, including breathing and feeding tubes? Or, would you prefer to be removed from life support?

While most of us prefer not to think about these things, the reality, said Sara Damiano, director of Advance Care Planning for Beaumont Health is that "100% of us will, ultimately, die. We'd all like to pass peacefully in our own beds at a ripe old age as we sleep. The reality, unfortunately, is that this doesn't always happen."

Enter the advance directive.

An advance directive is a legal document, also known as a medical power of attorney, that specifically outlines an individual's preferences for medical treatment. It is only used when the patient becomes too sick or injured to make decisions.

To promote patient empowerment, Beaumont is training and certifying employees and volunteers to provide free, one-on-one support to patients and families who wish to create an advance directive. In addition to answering questions, facilitators support individuals and their families throughout the process.

"We'd like people to think about the advance directive in the same way they think about other preventive health measures such as getting their cholesterol checked or blood pressure screened," Damiano said. "It's not just older people that are being encouraged to take action. An advance directive is for students heading off to college for the first time, and all people in each decade of their life; following the death of a loved one or after a divorce. Creating an advance directive enables all of us to maintain our voice and live our best lives, exactly as we choose."

Beaumont is rolling out this initiative to coincide with National Healthcare Decisions Day, April 16. NHCD seeks to inspire, educate and empower the community regarding the importance of advance care planning.

The first step in creating an advance directive, Damiano explains, is to visit beaumont.org/respecting-choices and review educational materials.

Once a patient has reviewed the information, he or she can begin thinking about which medical options line up best with his or her goals and values and start the conversation with family members. Issues to consider: preferences for cardiopulmonary resuscitation, life support and organ donation.

Then, select a patient advocate - a trusted individual who will honor your decisions. Next, download the document and write instructions.

"Learn about it. Think about it. Talk about it. Write about it and share it," Damiano said. "Beaumont will assist with advance care planning and ensure a patient's plans or instructions are clear. We also agree to maintain these documents as part of a patient's electronic medical record and ensure a patient's instructions are appropriately followed."

A few common myths surrounding the advance directive:

"An advance directive enables my patient advocate to access my medical records/personal information and make medical decisions for me immediately."

This does not occur until an individual is unable to make decisions themselves.

"I must hire a lawyer to create an advance directive and patient advocate designation."

Individuals can complete these documents on their own or with the support of a trained and certified facilitator.

"Once I've created an advance directive, my preferences are set in stone and cannot be changed or updated."

Preferences can be changed at any time.

"I don't need an advance directive unless I have a serious illness."

Everyone has the potential to have a decapacitating injury.

TRUE OR FALSE? "Once I turn in my advance directive to the hospital or my doctor, all hospitals and health care providers will be able to access them."

Unfortunately, there is no central database. Once you bring your copy to Beaumont, it will be scanned into your electronic medical record and accessible to your entire health care team. Be sure to give a copy to your primary care physician and all specialists.

For more information about creating an advance directive, attending upcoming educational workshops or scheduling an appointment with an advanced directive facilitator, call 947-522-1948, visit beaumont.org/respecting-choices or email respectingchoices@beaumont.org.