Caregivers’ Corner: Legal Documents Make Choices Clear

Joan Jackson
By Joan Jackson September 15, 2014 21:52

joan-jackson-best--214x300Our world changes and so do our options and choices as illness and age push us toward the end of life. Many of us would rather not think about it.

But having some control over those choices and being treated the way we wish is too important to leave to chance.

For caregivers and their loved ones, the topic looms large. Do you know your loved one’s wishes? Have you considered what care you would like? Have you chosen someone to speak for you if you cannot speak for yourself? Have you shared that information with others who need to know?

Everyone deserves to die with dignity, and everyone deserves to have their medical choices understood and respected.

Three vital but easily accessible legal documents can help:

Advance directive – This is recommended for anyone over 18 and particularly for the elderly. The directive spells out what treatment you would prefer if you are in a serious accident or develop an unexpected life-threatening illness.

It also allows you to appoint a person or persons you trust to make medical decisions for you if you are not able to do it yourself. An advance directive guides inpatient treatment decisions only. It does not guide emergency responders.

DNR – This is a pre-hospital Do Not Resuscitate form that tells emergency personnel what resuscitative measures you do and don’t want if you’re the subject of a 911 call. This form should be on your refrigerator or somewhere else immediately accessible for emergency responders.

Some people wear a DNR medallion to ensure their wishes are known.

POLST – Physician Orders for Life-Sustaining Treatment is a relatively new form specifically for patients who have been diagnosed as having less than a year to live. You fill it out with your doctor and both of you sign it.

This bright pink form goes on top of medical records and provides medical orders for your current treatment. It guides treatment decisions if you are admitted to a hospital.

POLST not only tells your health-care providers what medical interventions you want and don’t want, but also guides medical personnel in the emergency room. This is especially important if you don’t want to be kept alive with CPR, tubes or intensive care.

Advance directive, DNR and POLST documents work together to make sure your wishes are clear. If you know your loved one would want a POLST but is unable to express that choice, you may be able to handle it for them. Talk to your loved one’s doctor.

Also, you have the right to change your advance directive, DNR and POLST at any time.

Health-care providers will help with placing these documents in the right medical files. Copies can also be shared with key family members or friends, attorneys, social workers and others who might need to advocate for your wishes.

The Coalition for Compassionate Care of California, which helped develop POLST, has advance directive and POLST forms on its website, It offers materials to help you weigh the issues and talk with loved ones about this tough topic.

The Coalition’s information is available in a number of languages, and it has special materials for those with developmental disabilities. Call the CCC at (916) 489-2222 to learn more. Find a DNR form and details about DNR medallions online at

Joan Jackson is a partner with Peter Carrillo in Practical Dreamer (588-1835), whose services include free caregiver support groups sponsored by Area 12 Agency on Aging.

 Copyright © 2014 Friends and Neighbors Magazine

Joan Jackson
By Joan Jackson September 15, 2014 21:52
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