Make these decisions before you need them

How we love our independence. It's our most prized possession. We want to be in control of our life, and we have a right to be in control. But do we know how to safeguard this prized possession?

After all the decisions we have made over the years, we don't want someone else to decide when it comes to those important decisions about the end of our life. Yet many people still believe their most important documents are their life insurance policy, their will, or their trust .

It's the things that happen before our last days that we don't think about or discuss. I know from experience, as an adult child of aging parents, that this kind of conversation about advanced directives and the decisions that must to be made is difficult for an older, retired person or for someone who has caregiving responsibilities.

Statistics show we are living longer and that, no matter how old we are, we need to take a high-profile role in our long-term care and life decisions. But could delayed decisions and inability to pay attention to important matters result from fearing to face our own mortality?

Since Sept. 11 there has been new awareness among all age groups about this reality of life. Although we still might be reluctant to talk about it, our health care, long-term care and end-of-life decisions belong to us. We own them. But all too frequently, these deeply personal and important decisions are left to others.

I know from the many deaths in my family how difficult it is to talk about death and dying, but we restrict ourselves with reluctance and avoidance. Our denial, fears and powerlessness over death prevent us from communicating properly with family and physicians, forcing others to make decisions that may not be in our best interest.

I don't know anyone who wants someone else to decide whether they should undergo high-tech medical interventions or be given such treatment as mechanical ventilation or cardiopulmonary resuscitation. If we wish to maintain control over our whole life, we must empower ourselves before an illness or disability occurs.

Even the person with durable power of attorney or the health care surrogate needs to be informed.

Just last month an older gentleman faced some issues of control. He had a family member appointed to carry out his durable power of attorney and to be his health care surrogate. They both discussed what the gentleman wanted. He was living independently in an assisted living facility and developed a swallowing problem. He had discussed alternatives with his primary physician and at his suggestion sought further consultation with a specialist.

The man was clear-thinking and knew what questions to ask. He then decided to have a feeding tube inserted. It was his decision. It was explained to him that the procedure would provide him with better nutrition and help develop his swallowing; he also knew he could have the procedure reversed.

Almost immediately his decision created a family crisis. Although the man's relatives didn't want him to have the procedure, it was the man's decision.

In consultation with an attorney, the durable power of attorney goes into effect at the point of incapacity or severe disability. The man took time to inform himself and maintained his independence.

We must maintain control over all aspects of our life. We must also plan and discuss our wishes with others and educate them to understand their proper roles. Discussions with family members before a crisis or illness may help reduce anguish and indecision.

Communicating values and preparing documentation helps solidify personal decisions. Don't rely solely on advance directives documentation. Make sure you have a clear personal values statement that your family member, doctors or someone else can use to carry out your wishes.

Planning ahead can bring peace of mind to everyone. Some questions to begin with may be:

Do you know where your living will is? Does it reflect the new state statutes? Are family and friends aware of your living will?

Your living will doesn't have to contain legal jargon that you don't understand; it should reflect you and what you want. For more information about a personal values statement, questions and information, please contact me at the address below.

- Ethel M. Sharp is executive director of Aging Matters Inc., a nonprofit network for family caregivers and elder care. You can write her in care of Seniority, the St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731. When seeking more information, please enclose a stamped, self-addressed envelope and include your telephone number, with area code.

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