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Make (your) wishes known with a living will, by Lisa Stearns (The AZ Republic)

I found this practical article today and wanted to share it, as it is an important topic for all of us. I'm reprinting Dr. Lisa Stearns' article from The Arizona Republic, Monday, Feb. 17, 2014:

As a physician who has seen families torn apart by tragedy, I can't stress enough the importance of a living will, which is a written statement detailing a person's desires regarding their medical treatment in circumstances during which they are no longer able to express informed consent.

For example, if you're in a car accident and have severe brain damage, what would you like your family to do for you? Your family will remember who you were before the accident and may be in denial about how grave the situation is. By writing down your wishes, you are able to guide them through a difficult, hope-crushing, guilt-ridden decision-making process.

A living will is something that you can create over the dinner table. In Arizona, you don't need an attorney or a notary to make it legal, just a witness.

Top five things to include:

1) Appoint your medical power of attorney (MPOA). This should be someone who you are comfortable with having a frank discussion about your wishes and who is comfortable stating your wishes to medical personnel and family members. If you do not have an MPOA, a doctor can override a living will. List a second individual as a backup. In Arizona, if you have not designated an MPOA, a spouse followed by a parent then firstborn adult child is appointed. If no one is available, the state will appoint one for you. Be aware that your MPOA is only responsible for medical decisions, not financial ones.

2) Write down what "living" means to you. Everyone has a different outlook, often based on religious or cultural beliefs. If you're incoherent and kept alive by machines, is that consistent with your beliefs?

3) Under which scenarios would you not want to be kept alive? Under what circumstances would you want technology to keep you alive and for how long? Do you want a breathing tube if you are unable to breathe on your own? Do you want a feeding tube if you can't swallow? When would you want to be transferred to a nursing home to live on a ventilator and fed with a feeding tube?

4) If modern medicine is keeping your alive, how long do you want to live like that? Be specific in terms of a time frame - days, weeks, years. If no decisions are express to the medical team, the team will move forward and place tubes and transfer you to a nursing facility to sustain your body.

5) If you are kept alive, what type of care do you want? Where do you hope to be placed? You may look for ventilator nursing homes ahead of time. You will need long-term care insurance to pay for these services... If you don't have a policy, discuss which assets you would like your family to use to pay for your care, which can cost several thousand dollars a week.

Once you've answered these questions, let your medical power of attorney know your intentions and then type or write your living will in the presence of a witness. include the date, clear and concise answers to the above questions, your signature and the witness's signature. Make a copy for yourself and your medical power of attorney. Keep the document in a safe but accessible place and let your close family members know where to find it. Consider keeping a copy in your wallet for health-care teams.

You can also contact an attorney to create your living will or use forms available online.

To facilitate a discussion with loved ones, consider hosting a discussion at a dinner party to help lighten the topic of death. Bringing people together who know and trust each other may make the topic a little more palatable.

I'd also like to mention the "Five Wishes" document that you might have a look at to help you with these kinds of questions and decisions. It's a document you can obtain through the Five Wishes website that helps walk you through these kinds of health care related questions and hope & desires you may have.

To our Health, Wealth, and Joyful Preparedness, Dancing heart~~~~

Dr. Lisa Stearns is founder and medical director of Center for Pain and Supportive Care in Phoenix and an expert in interventional therapy for cancer and chronic pain.

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