Posted by:  Heinz Brisske

We probably all, to some degree, regardless of age, gender or station in life, harbor a fear that, near the end of our lives, we will be “committed” to a nursing home. This Washington Post article points out that “the promise is a red herring.” What the person is really asking is: “‘Promise me you’ll protect my dignity, promise you’ll protect my privacy, promise to make sure I don’t live in pain.’”

I am reading a book that discusses the issues involved in aging and long-term health care: Being Mortal: Medicine and What Matters in the End by Atul Gawande. The book was recommended to me by my son, who is a mere 34 years old, but even he felt that it was important. It is also on my wife’s book club reading list for this month. I highly recommend that everyone reading this post get the book and read it, and then discuss it among the members of your family.

These are important issues, and they need to be understood and discussed, especially among your loved ones. It is never too early to begin that discussion in everyone’s family. And coincidentally, it is never too early to memorialize your decisions in your formal legal documents, your advance health care directives. In Illinois, the most important of those documents is the Power of Attorney for Health Care. You may also want to discuss a Living Will and HIPAA Authorization with your estate planning attorney.

Finally, for those of us who are within a year of our deaths, a POLST (Physician’s Order for Life-Sustaining Treatment, formerly called a DNR, or Do Not Resuscitate order) becomes relevant and may be appropriate. A POLST, like a DNR, is not a legal, but a medical document.  It must be prepared in consultation with your physician, and must be countersigned by him or her to be valid.

The bottom line is communication. Make sure that your wishes are known. Not just about long-term health care generally, but also about what treatment options you would prefer.  Most important, be clear about your end-of-life wishes. These are not easy things for anyone to talk about, but the guilt associated with making decisions for a loved one, not knowing if the decision being made is the right one, can be overwhelming.

Be thoughtful; be clear; be direct. I have those discussions with my clients on a regular basis, reminding them of the importance of being open and forthright about their wishes.

It is as important as anything you are likely to do in your life.