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March 19, 2013

Take control of your future when planning end-of-life care

by: Kimberly Barone Baden

After hearing about the recent incident at Glenwood Gardens, an independent living facility in Bakersfield, Calif., I was reminded that making a clear decision early on regarding measures such as CPR or a do-not-resuscitate order (DNR) can avoid confusion when an emergency arises.

In the Glenwood incident, an 87-year-old resident at the facility went into cardiac arrest. No one performed CPR to try to save her life. While the details of this incident are still unclear, it shows the extreme importance of planning for and making end-of-life decisions. Although difficult to discuss, it is essential that families prepare as best they can—from fully researching assisted living or nursing home facilities to discussing final wishes.

I tell my friends and family members that it is always better to be armed with more information than you need than none at all when making life altering decisions for yourself or a loved one.

First, establish whether or not you or a loved one would like to have a DNR. Long-term care facility employees typically know from looking at the front of a resident’s chart whether that person is a full code or a DNR. Having this order in place before an emergency arises will give everyone piece of mind that you or your loved one are being cared for in the manner preferred and that panic regarding end-of-life wishes will not set in during an emergency.

Equally important is choosing the right facility in which you or your loved one will reside, such as independent living, assisted living or skilled nursing facility, or even in-home health care. When visiting a facility, confirm whether that facility is aware of your loved one’s health care directives, and ensure that it will provide such services in the event of an emergency. Resources such as the “Guide to choosing a nursing home” link on Medicare’s website offers relevant information. The page also provides a comparison tool that allows patients to compare home health services in their areas, additional links to a checklist, and information about nursing home inspections, resident rights and more. In addition, if considering home health care, know who you are bringing into your home and what expectations you have of them. From performing strictly nursing/health care tasks to providing complete care, including even light housekeeping duties, consider what level of care you or a loved one need and set clear expectations from the start.

Lastly, living wills are becoming more popular; however, many people still do not have them. A living will is a set of written instructions that a person provides detailing what actions should be taken if they are no longer able to make decisions for themselves due to illness or incapacity. While you are in good health, electing a power of attorney and a healthcare power of attorney will give you piece of mind that someone you trust and selected will have legal authority to make decisions on your behalf if you should be unable to make decisions for yourself. Also, parents with younger children need to seriously consider who their power of attorney will be as this person will make decisions for their children should both parents become incapacitated and unable to make decisions. There are many online sources where living wills and other health care directives can be accessed free-of-charge or for nominal fees.

For more information on these issues, visit some of the following websites:

Why leave important health care decisions up to someone else when you are able to make them for yourself?