Seniors and their caregivers sometimes have to make decisions regarding medical treatment for which they are not prepared.  As frightening as it may be to discuss medical care for loved ones in life-or-death situations, the situation can be even more difficult if no guidelines are available to help families make such emotionally-charged decisions. 

Some of the more common medical questions that seniors should consider so they can provide such guidance are: If you were terminally ill and near death, would you choose to be resuscitated if your heart stopped beating?  What medical treatment would you choose if you had a stroke that left you completely dependent upon other people?  Would you want to be kept alive with the help of a respirator?  While these questions can be hard to answer in times of good health, it's important that seniors share the answers to these difficult questions with their caregivers.

The following suggestions, from the Foundation for Health in Aging (FHA) can help older adults openly discuss their end-of-life wishes with caregivers and physicians, and understand how to create an “advance directive” a document that outlines their wishes regarding medical care.  An advance directive details what kind of medical treatment and procedures a patient does and does not want. The document is only used by healthcare providers when a patient is no longer able to make decisions or communicate the kind of care he or she wants. 

Preparing an advance directive doesn't have to be complicated. The FHA offers this advice:

·         Talk to relatives, friends and health care providers and give them copies of the advance directive. Spell out your wishes so family, friends and providers understand and are prepared. The ideal advance directive includes two parts: a “Living Will” that specifies the care you want, and a “Durable Power Of Attorney For Health Care” that names the person you want to make decisions for you when you're unable to do so.  It's a good idea to make multiple copies of the document to give to your doctor, hospital and loved ones.  A copy should also be kept with your medical records.

·         Keep a copy.  Put another copy of the document in a safe, easy-to-find place, and let loved ones know where it is.  You may also want to put a note in your wallet explaining that you have an advance directive and where it can be found.

·         Review and revise as needed.  Advance directives do not expire and remain in effect until they are changed.  Over time, feelings may change about the kind of medical treatment a patient wants or doesn't want.  If this is the case, be sure to revise the advance directive and give everyone a copy of the new version.

“Making difficult medical decisions about your own health, or someone else's, is very stressful regardless of how much preparation is done,” says David Casarett, M.D., Chair of the American Geriatrics Society (AGS) Ethics Committee.  "However, there are options available to help reduce stress during these difficult times and to ensure that a patient's medical wishes are being followed.”

For more information visit the FHA Web site at healthinaging.org.