By ELIZABETH POPE
© St. Petersburg Times, published March 28, 2000
Advanced directives is not the Pentagon's term for a detailed map, and a living will is not a will you make when you're still alive.
Here are some important terms in making end-of-life decisions.
ADVANCE DIRECTIVES: The term for your oral and written instructions about your future medical care in the event you cannot speak for yourself. In Florida, there are two forms: a living will and a designation of a health care surrogate to make medical decisions for you if you are unable (known as a medical power of attorney in other states). You don't need a lawyer to execute the paperwork, but both forms must be signed by two witnesses, one of whom cannot be a spouse, blood relative or heir. Your health care surrogate cannot be a witness. Forms are available free or at low cost from several sources. Put the originals in a secure, but accessible place, not the safe deposit box. Make several copies to give to family members, clergy, your doctor and surrogate.
LIVING WILL: A document giving your medical care instructions to the doctor and family if you are too sick to make or express decisions. A living will in Florida becomes valid only when your doctor declares you in a terminal or end-stage illness or in a persistent vegetative state. It does not mean you won't receive any care, but it allows you to limit feeding tubes, respirators, intravenous therapy, use of antibiotics and resuscitation. You can also ask for adequate pain relief, even if it hastens death.
Living wills and other documents are available free or for a small fee from:
Hospice of the Florida Suncoast, 300 East Bay Drive, Largo, FL 33770-3770. (727) 586-4432.
LifePath Hospice, 3010 W Azeele St., Tampa, FL 33609, (813) 877-2200.
Aging With Dignity, an easy-to-understand living will, called Five Wishes, includes sections on what you want loved ones to know and how you want to be remembered. Spanish-language version available. Contact Aging With Dignity, P.O. Box 1661, Tallahassee, FL 32302-1661. (850) 681-2010. Web site: http://www.agingwithdignity.org.
Choice in Dying: Living wills for each state are available from this non-profit organization. Call (800) 989-9455, or download documents at http://www.choices.org
Project GRACE offers an advance care plan document that is easy to use and describes the patient's wishes in several medical scenarios. Call toll-free (877) 994-7223 for a copy.
HEALTH CARE SURROGATE: Makes health care decisions when two doctors agree that you are physically or mentally incapable of decision-making at any time, not only at the end of life. You choose a surrogate by filling out a designation form witnessed by two people. If you don't choose a surrogate, then your next-of-kin, known as a proxy, makes your health care decisions. If there is no family, the state appoints a guardian. Choose someone who shares your beliefs and who will fight for you. Don't choose more than one person. Be sure to discuss your medical care choices in a variety of scenarios with your surrogate.
DNR, OR "DO NOT RESUSCITATE" ORDER: For most people, a living will and designation of a health care surrogate are enough. If you have a terminal illness that limits life expectancy with no hope of recovery, you may want to fill out a DNR order and have it signed by your doctor. A living will may not be honored in an emergency.
Important: There is only one DNR form in Florida that emergency personnel will accept. It is printed on yellow paper and must be displayed prominently, on the refrigerator, for example. If someone calls 911, paramedics are required by law to resuscitate you, unless a DNR form is available. They won't hunt through drawers or your purse looking for it.
To order copies of DNR forms, call Jerri White of the Florida Department of Health's Bureau of Emergency Medical Services, (850) 245-4440, ext. 2742.
PALLIATIVE CARE, COMFORT OR HOSPICE-TYPE CARE: Such care does not mean "giving up hope," but focuses on the patient's medical, emotional, social and spiritual needs by controlling pain and relieving suffering.
-- Sources: Hospice of the Florida Suncoast, Choice in Dying, Aging with Dignity