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Does dad need a nudge on planning?

By HANA OSMAN
Published July 26, 2005

EDITOR'S NOTE: Last month we featured a new question-and-answer column, "Ask the Experts." The answer is written by a member of the University of South Florida's Collaborative on Aging, a group of faculty members who are involved in research on aging, ranging from basic science to public policy analysis. Collaborative members have extensive experience providing care for older adults and their families, or advising policymakers on improvements in elder care. Readers are invited to submit questions to "Ask the Experts" through the St. Petersburg Times, and some of them will be published. Names may be withheld upon request. The COA cannot respond to individuals. To learn more about the Collaborative on Aging, visit aging.cas.usf.edu.

Submit questions to: Ask the Experts/Seniority, St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731.

Q. My 88-year-old dad lives alone and seems to be happy doing so. He won't make out a will (he says he has nothing to leave anyone) and shuts down whenever this or any end-of-life topic arises. What can I do to get him to be more responsible about his affairs?

M.R. Inverness

Answered by Hana Osman

Talking about wills and planning for end-of-life is very difficult. Many people postpone this discussion until it is too late.

Wills addressing property distribution after death are particularly important when assets are involved. With no significant assets, people may not see a need for the expense and effort to create a will.

Explain to your father the benefits of thinking about health care planning, for himself and for you. His wishes are more likely to be honored if he expresses them in writing, and the benefit for you is that you can carry out his wishes knowing you are making the decisions he would have made.

When a person is mentally competent, he has the choice of accepting or declining any medical intervention. But when his mental capacities become diminished, family members frequently find themselves in the difficult position of having to make decisions without clear guidance.

There are a number of ways your father (or any person) can make his health care wishes known in advance. The most popular are the living will, the appointment of a health care surrogate and the outpatient do-not-resuscitate (DNR) order.

A living will allows him to list treatments - such as kidney dialysis or artificial hydration and nutrition - he is willing to accept or reject. Florida living wills are available online at http://www.flsenate.gov/welcome/living_will/livingwill.pdf Your father can plan for his health care by appointing one other person he trusts to make decisions on his behalf.

Health care surrogate forms are available online at http://www.flsenate.gov/welcome/living_will/designation.pdf Neither form requires notarization or a lawyer. Both just need to be signed, dated and witnessed by two adults.

Another document is the durable power of attorney. People are more familiar with this document because it is similar to the general power of attorney except that it can also apply to health care decision making. The durable power of attorney form can be purchased from any office supply vendor. The durable power of attorney must be notarized.

Finally, your dad can ask his doctor if a do-not-resuscitate order is appropriate. This is a doctor's order addressed to health care professionals instructing them to not attempt resuscitation if the person's heart or breathing stops. This document must be completed by the doctor, but may not be appropriate for your dad's condition. A discussion with the doctor will help make this decision.

The most important benefit of completing any of these documents is that you can discuss your dad's health care wishes with him in advance and assure him that you will follow his wishes.

Answered by Hana Osman, an assistant professor in the Department of Community and Family Health in the USF College of Public Health. Her publications are in the areas of advance care planning, health care decision making, and public health.

[Last modified July 22, 2005, 11:20:06]