By Susan Baida

End of Life Care is very personal, emotional and controversial.  It is a topic that many people are pressing in the debate on Healthcare Reform.

When my uncle suffered from a pulmonary embolism that left him in an irreversible coma, my mother was determined to keep him alive in hospice care.  He was breathing on his own, but was diagnosed as brain dead.  The damage caused by the lack of oxygen flow to his brain was too great.   She couldn’t bring herself to stop the intravenous feedings which would result in him dying within a few days.  So he was kept alive with daily feedings, baths and massages.  He lasted this way for 20 months until his death in May 2008.

My uncle did not have advanced directives which are documents such as a living will and healthcare proxy that provide clear direction of a person’s wishes should they become incapacitated.  He was only 56 years old and didn’t think about this type of preparation because he was relatively healthy beforehand.

I think most people are like my uncle and don’t think about getting these documents until they are in early stages of a long term disease.  My father-in-law is a perfect example.

When my father-in-law was first diagnosed with Parkinson’s disease at age 77, it appears he began immediate preparations with his lawyer.  After having the documents drafted and signed, he told my husband, John, about them and where they could be found.  While John did not want to think about end of life care for his father, he was both surprised and impressed by his father’s level of preparation and detail.  His healthcare proxy identified John as having power of attorney should he become incapacitated.  His living will stated explicitly that he did not wish to be kept alive if the medical diagnosis indicated no hope for his full recovery.

On July 24, 2007, my father-in-law, at age 83, suffered from a stroke that left him in a comatosed state.  He was able to breath on his own but needed a feeding tube to get nutrition.  The doctors conducted various exams.  We learned that he not only suffered from a stroke but that he had advanced cancer which had not previously been diagnosed.   The doctors gave the family the diagnosis that his conditions were irreversible and that he would pass away within 6-8 weeks if maintained on life preserving devices.

John and the family had little choice but to honor my father-in-law’s wishes as outlined in his advanced directives.  One day later, he was taken to a hospice where he was kept “comfortable” with pain medication and warm blankets.  Three days later, he passed away peacefully and with dignity surrounded by his family.

Both my uncle’s and my father-in-law’s deaths were incredibly tragic and painful to witness.  However, I think the decision-making process was made easier on John’s family because my father-in-law documented his wishes which relieved them from the burden of these difficult end-of-life decisions.

The lesson learned here is to prepare for end-of-life care with advanced directives.  I don’t think it is ever too early because, with the unpredictability of life, we can become incapacitated at any age.   In fact, my husband and I, despite being in our 40s, have completed advanced directives in case something should happen to us and we become incapacitated and unable to execute our wishes.

Visit our Legal Documents page to learn more about advanced directives.