I recently lost a senior family member to a brain aneurysm. It was something no one expected. She was in good health, exercised daily, and took care of herself. One day she was carrying on an active life and the next she was in a coma. Her husband was forced to make the decision about whether to have doctors operate. He was told even if the surgery was successful, she would be in a wheelchair for the rest of her life. My first thought was how do you make that kind of decision for another person? Surrounded by her children and other family members, the decision was made that they would not operate. Relying on his strong Christian faith, her husband decided to have the feeding tubes removed and she passed away.
Soon after, I learned about a man in his early forties who also died of a brain aneurysm. However, his wife had made the decision to have the operation in hopes he would recover. After the surgery, the man never woke up. He remained in a coma for over a year and was transferred to a nursing home. Eventually, his wife had to make the decision to have the feeding tubes removed.
Possibly the worst burden you may ever have to bear is making life and death medical decisions for another person. Even if your loved one made advance directives, such as a living will, and you know his or her wishes, it can be very difficult to carry them out. When this type of thing happens, you want the person you knew to wake up and be just as they were before. If there are no health care directives in place and you never discussed each otherís wishes regarding end of life care, the guilt and doubt of removing life support can plague you for a lifetime.
Be Prepared by Making an Estate Plan
The events that may cause a person to be in a persistent vegetative state can happen at any age, regardless of health or family history. Some of the most common events that can put a patient in a coma are strokes, car accidents, falls, head trauma, and brain aneurysms. Statistics show we are all at risk, even young people. For example, according to some estimates, as many as one person in every fifteen will suffer a brain aneurysm at some point in life.
Circumstances entirely out of your control may put the decision to continue or end your life in someone elseís hands. If you have not stated your wishes in a legally enforceable document and communicated what you want to someone close to you, it is much more likely the medical decisions made when you are incapacitated will be contrary to your
Make Your End of Life Wishes Known
1. Execute advance directive forms that are enforceable in your state, including a living will and durable power of attorney for health care. Note: the names used for these types of forms are different from state to state. Also, the enforceability of certain advance directives varies, depending on applicable state laws.
If you are suffering a terminal illness or painful chronic disease, you may also want to get information about making a do not resuscitate order. See DNR Orders. Consult a lawyer if you have questions about advance directives in your state. For links to free living will forms by state, see medical decision laws.
2. Give a copy of your advance directives to your primary care doctor and any hospital where you plan to receive treatment. Follow their instructions for submitting advance directives to a health care provider.
3. Another step you can take to ensure your end of life wishes are on record and may be accessed by your treating physician is to file your advance directives with the US Living Will Registry. Information about when a physician can access advance directives on file with the Registry is available on their website.4. Discuss your end of life wishes with the person you name as your agent for health care as well as your spouse, partner, parents, adult children, siblings or other next of kin. Explain your preferences regarding medical decisions about life support, high risk surgeries, medication for pain, and related issues. If your agent or other loved ones may disagree with your end of life wishes, attempt to resolve those issues and reach agreement that they will carry out your directives. See things you can control about what happens when you die.Religious beliefs and differences of faith are a common source of legal disputes over withdrawal of life support. Attempt to resolve potential disagreements while your health permits. If necessary, have an attorney guide you on how to ensure your last wishes are honored.
Deciding Your Own End of Life Wishes
When you sit down to review advance directive forms, such as a living will or durable power of attorney, it is often very difficult to decide whether you want life sustaining medical procedures and under what circumstances. After all, it is not uncommon for patients to awake from a coma after being unconscious for several months or longer. At the same time, most people do not want to burden their family with the high cost of long term care if they are unlikely to recover.When you make a living will, it is also recommended you make a health care POA. A health care power of attorney allows you to appoint an agent to make medical decisions on your behalf if you are unconscious or otherwise incapacitated. Some people feel better leaving their end of life medical decisions to another person. However, you should still outline your basic preferences regarding life sustaining measures in a living will. After you make a living will, the next challenge is choosing the person to name as your agent for medical decisions. Sometimes the decision is obvious. But for some people it is difficult to decide whom they can trust with their life.A living will is not the same thing as a last will and testament. A will only applies to what happens to property in your estate after you die. When you execute estate planning documents, such as a will or living trust, it is also recommended you make a living will stating your preferences on medical treatment if you are unable to communicate.