GUEST BLOG BY BETSY HOWE - END OF LIFE WISHES - HOSPICE, STEP ONE - June 28/29, 2010

SUGGESTIONS FROM A CAREGIVER—Support Part 7 
End-of-life Wishes – Hospice Step One by our member, Betsy Howe

When is the right time to pick a hospice?  As Dave and I found out, belatedly, the right time to start picking a hospice is right away.  Start the three-part process when you complete/review your legal documents, perhaps even before you interview possible care facilities.  Why?  It is important that the care-receiver has their wishes honored.  

Many things in life are out of our control.  But we can have a say in how we are treated when seriously ill at the end of life if we take the right steps.  In order to pick a service which will honor our wishes for end-of-life care and comfort, we need to determine what those wishes ARE.

There is an excellent resource called ‘Five Wishes’ living will which is available through www.agingwithdignity.org. Our attorney recommended that we first complete a will, with extra witnessed questions to assure there would not be a question of competence, get a durable POA (power of attorney - financial and medical).  After those steps is the time to complete the ‘Five Wishes’.  ‘Five Wishes’ is considered a legal document in Nebraska.  We wrote on the front of our ‘Five Wishes’ document that the instructions inside did not supercede, but rather added to our POA.  Once completed, we both provided our ‘Five Wishes’, along with our POA to all hospitals and doctors we saw during our journey—Dave’s to his and I to mine. 

The Alzheimer’s Association-Great Plains Chapter has a number of useful pamphlets on a variety of topics.  One pamphlet was a great help to Dave in understanding what Alzheimer’s patients die of and the death process.  This pamphlet helped him make decisions while he could.  He decided  on what he did NOT want, treatments that would not change the outcome and merely prolong the inevitable or add to his discomfort rather than comfort at end-of-life  This Alzheimer’s Association pamphlet and Dave’s ‘Five Wishes’ helped me come to terms early with Dave’s end-of-life wishes, making them easier for me to carry out when the time came.

The ‘Five Wishes’ document from the Aging With Dignity organization has five sections, hence ‘five’ wishes.  The sections are entitled:  The Person I Want to Make Care Decisions for Me When I Can’t; The Kind of Medical Treatment I Want or Don’t Want; How Comfortable I Want to Be; How I Want People to Treat Me; and What I Want My Loved Ones to Know.  The questions in this document helped Dave and I even KNOW what some things to think about might be. After completion, we each shared our individual wishes with our families as well as our POA designee.  I think it helped our family to know ahead of time what Dave’s wishes were, so they could accept his decisions well ahead of time.  Of interest:  While Dave decided originally that he did not want special music while dying, as he lay at home on his deathbed he asked our son to play the piano for him.  That was the only thing that changed from his carefully thought out ‘Five Wishes.’

Now both you and your loved one have some tools to help you determine end-of-life wishes, medically and comfort-wise.  Next time we will investigate the second step of the three-part process of selecting a hospice that will honor your end-of-life wishes.

©Copyright 2010 Betsy Howe

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