Commonly held myths about end-of-life issues

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September 26, 2013

Living wills and health care proxies — documents known as advance care directives — give you a voice in decisions about your medical care at the end of life. Without these documents, choices may be left up to a doctor or a judge — someone who does not know your values, beliefs, or preferences. This Special Health Report, Living Wills: A guide to advance directives, the health care power of attorney, and other key documents, will help you plan ahead and create legal documents to guide decision makers at this important time. Commonly held myths about end-of-life issues Some people don’t have a health care power of attorney or living will because they don’t realize how important these documents are. Others worry that such documents mean they are signing their lives away. Not so. These powerful documents make sure that you get the treatment you would want for yourself if you couldn’t communicate your wishes. Here are a few myths that shouldn’t get in the way of creating a health care power of attorney or living will: Myth: More care is always better. Truth: Not necessarily. Sometimes more care prolongs the dying process without respect for quality of life or comfort. It’s important to know what interventions are truly important. It’s often impossible to know that in advance. That’s where the advice of a healthcare team is invaluable. Myth: Refusing life support invalidates your life insurance, because you are committing suicide. Truth: Refusing life support does not mean that you are committing suicide. Instead, the underlying medical problem is considered to be the cause of death. Myth: If medical treatment is started, it cannot be stopped. Truth: Not starting a medical treatment and stopping a treatment are the same in the eyes of the law. So you or your health care agent can approve a treatment for a trial period that you think may be helpful without fear that you can’t change your mind later. However, be aware that stopping treatment can be more emotionally difficult than not starting it in the first place. Myth: If you refuse life-extending treatments, you’re refusing all treatments. Truth: No matter what treatments you refuse, you should still expect to receive any other care you need or want — especially the pain and symptom management sometimes called intensive comfort care. Myth: Stopping or refusing artificial nutrition and hydration causes pain for someone who is dying. Truth: Unlike keeping food or water from a healthy person, for someone who is dying, declining artificial nutrition or intravenous hydration does not cause pain. For more on setting goals for end-of-life care and avoiding common pitfalls, buy Living Wills: A guide to advance directives, the health care power of attorney, and other key documents, a Special Health Report from Harvard Medical School. Share this story: Digg Facebook Twitter

News and Views from the Harvard Health Blog Study suggests testing bone health in older people less often may be safe One key instruction in the operating manual for healthy aging is remaining vigilant about osteoporosis. How often to be tested for early signs of this bone-thinning condition is still an open question. Read more.

Keep your advance directive safe but accessible Many people understandably want to keep their living will and health care power of attorney forms in a secure place. But if these documents are locked away in a safe deposit box, they won’t be much help if you’re unexpectedly hospitalized. Here are some people who should have copies of your advance directives and other places they should be filed. •  Your health care agent and any alternative agents. All should have a copy of your health care power of attorney (and your living will, if you have one). In an emergency, your agent may need to fax the documents to doctors or a hospital. •  Your doctor. A copy of your advance directives should be in your file and medical record. •  Your hospital chart. If you are in the hospital, ask to have a copy of your advance directives put in your chart. (Your health care agent or a family member should do so if you are unable to do it.) •  A safe spot in your home. File the original documents in a secure place in your home — and tell your agent, family, and friends where you put them. Hospitals may request an original, so it’s important that someone can find the documents when necessary. The National Hospice and Palliative Care Organization suggests noting on all copies of the documents where the originals are stored. •  Carry it with you. Put a card with your health care agent’s name and contact information in your wallet or purse. Also note on the card where you keep the original and additional copies of your directives. If you have a do not resuscitate order (DNR), remember that you or your health care agent may be required to produce a signed form, or you may have to wear a special bracelet identifying that decision. If a lawyer drew up your advance directives, ask whether he or she will keep a copy, and for how long. For additional information on the legal documents you should prepare and keep, buy Living Wills: A guide to advance directives, the health care power of attorney, and other key documents, a Special Health Report from Harvard Medical School. Share this story: Digg Facebook Twitter

Featured in this issue Living Wills: A guide to advance directives, health care power of attorney, and other key documents Featured content: • What are advance directives? • Step One: Deciding on your wishes for care • Step Two: Choosing a health care agent • Step Three: Creating your advance directives • Troubleshooting: Pitfalls, fixes, and tips for tough conversations   ... and more! Click here to read more »

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