Difficult but Necessary Conversations During the Holidays

woman putting hand on elderly man's shoulder

As the holiday season nears and families begin to spend extended periods of time together, MRHC encourages that, amidst the joyous celebrations, it’s crucial to recognize the importance of discussing a topic often overlooked: advance care directives. While these conversations might seem difficult or uncomfortable, addressing them during the holidays can bring families closer and ensure everyone’s well-being.

What are Advance Care Directives?

Advance care directives are legal documents that allow individuals to outline their healthcare preferences. They serve as guiding principles for medical decisions when a person is unable to express their desires due to illness or incapacity. An advance directive can help you think ahead about what kind of care you want to receive as well as guide your loved ones and healthcare team in making clear decisions about your health care when you can’t do it yourself.

All patients have rights that include privacy, informed consent, information about your condition, and information about advance directives. Advance directives can protect these rights if you ever become mentally or physically unable to choose or communicate your wishes due to an injury or illness. Advance directives can also limit life-prolonging measures when there is little or no chance of recovery.

“Advance directives help you protect your right to make medical choices that can affect your life,” said Julie Hodne, R.N., Education Coordinator at MRHC. “They help your family avoid the responsibility and stress of making difficult decisions on your behalf. Advance directives also help your physician by providing guidelines for your care.”

Having these in place empowers individuals to maintain control over their healthcare choices, ensuring that their preferences are honored even when they can’t voice them. Advance care directives also facilitate discussions among family members, fostering a deeper understanding of each other’s values, beliefs, and healthcare preferences. These directives come in various forms, including living wills, healthcare powers of attorney, and do-not-resuscitate (DNR) orders.

Discussing Advance Care Directives During the Holidays

The holiday season presents a unique opportunity for families to gather and connect on a deeper level. While conversations about end-of-life care may initially appear daunting, the holidays can provide a supportive environment for these discussions. Here are a few ways to initiate conversations about advance care directives during the holidays:

  1. Create a Safe Space: Choose a comfortable and quiet setting where family members can openly express their thoughts and concerns without judgment. Emphasize the importance of respecting each other’s perspectives.
  2. Share Personal Stories: Encourage family members to share personal experiences or stories related to healthcare decisions. This can help normalize the conversation and demonstrate the significance of having a plan in place.
  3. Use Resources: Utilize educational materials or seek guidance from healthcare professionals to facilitate discussions and clarify any uncertainties regarding advance care directives.To get a durable power of attorney for health care or a living will, you will need to complete a form available from the Iowa State Bar Association website. Keep a copy in a safe and secure place and provide a copy to your physician to be kept as part of your medical records. Your Durable Power of Attorney for Healthcare will also need a copy. Give copies to a relative or friend who is likely to be notified in an emergency. Review your advance directives regularly and make changes when necessary. Inform you physician, family, and POA of any changes.

    Another document to be considered for any individual who is frail and elderly or who has a chronic critical medical condition, or a terminal illness is the IPOST form (IOWA PHYSICIAN ORDERS for SCOPE OF TREATMENT). The original form is strongly encouraged to be accompanied by the person it is written for. You can discuss this with your medical provider and find more information about here.

  4. Focus on the Positive: Highlight the benefits of having these directives in place, such as reducing stress for loved ones and ensuring that individual preferences are respected.

Hodne suggests that “if you need help preparing your advance directives or if you would like more information, contact your legal counsel, healthcare provider, or any hospital, hospice, home health agency, or long-term care facility.” Hodne reminds everyone that “planning is the key to protecting your rights!”

As you gather with loved ones this holiday season, take the opportunity to engage in meaningful discussions about advance care directives. These conversations, though challenging, can strengthen family bonds and empower individuals to make informed decisions about their healthcare.

Plan Ahead for End-of-Life Medical Care

comforting an elderly lady

Do your loved ones and medical providers know what type of medical treatment you prefer? By planning ahead, you can get the medical care you want, avoid unnecessary suffering, and relieve caregivers of decision-making burdens during moments of crisis or grief. You can also help reduce confusion or disagreement about the choices you would want people to make on your behalf.

An advanced directive is a legal document that explains how you want medical decisions to be made if you cannot make the decisions yourself. This directive lets your healthcare team and loved ones know what kind of health care you want or who you want to make decisions for you when you can’t. An advance directive can help you think ahead about what kind of care you want to receive as well as help guide your loved ones and healthcare team in making clear decisions about your health care when you can’t do it yourself.

“Advance directives help you protect your right to make medical choices that can affect your life,” said Julie Hodne, R.N., Education Coordinator at Manning Regional Healthcare Center. “They help your family avoid the responsibility and stress of making difficult decisions on your behalf. Advance directives also help your physician by providing guidelines for your care.”

All patients have rights that include privacy, informed consent, information about your condition, and information about advance directives. Advance directives can protect these rights if you ever become mentally or physically unable to choose or communicate your wishes due to an injury or illness. Advance directives can also limit life-prolonging measures when there is little or no chance of recovery. For example, advance directives may help patients decide if they want cardiopulmonary resuscitation (CPR), artificial nutrition or hydration, intubation, ventilators, or dialysis. They can also address your feelings about pain control and comfort care.

Let your values be your guide when creating your advance directives. Consider what is important to you. That may include passing on without pain and suffering, being able to make your own decisions, leaving your family with good memories and not burdening them with difficult decisions, acting according to your religious beliefs, or to be with your loved ones at your time of passing. Discuss your feelings with your family, friends, physician, religious leader, or your lawyer to consider what is best for you.

Advance medical directives are most commonly in the form of a living will or a durable power of attorney for healthcare. Both documents allow you to give directions about your future medical care. To get a durable power of attorney for health care or a living will, you will need to complete a form available from the Iowa State Bar Association.

To receive the form in the mail, send a self-addressed, stamped envelope to:  Iowa State Bar Association, 625 E. Court Avenue, Des Moines, Iowa 50306, with the following information in the envelope: your full name, address, and date of birth. You can also print and download the selected form here.

Once you have the forms, put your wishes in writing and be as specific as possible. Review your advance directives with your family, friends, physician, and power of attorney (POA). You will need to sign and date your advance directives and have them witnessed and notarized.

Keep a copy in a safe and secure place and provide a copy to your physician to be kept as part of your medical records. Your Durable Power of Attorney for Healthcare will also need a copy. Give copies to a relative or friend who is likely to be notified in an emergency. Review your advance directives regularly and make changes when necessary. Inform you physician, family, and POA of any changes.

Another document to be considered for any individual who is frail and elderly or who has a chronic critical medical condition, or a terminal illness is the IPOST form. IPOST stands for the IOWA PHYSICIAN ORDERS for SCOPE OF TREATMENT. The original form is strongly encouraged to be accompanied by the person it is written for. You can discuss this with your medical provider and find more information about IPOST from the Iowa Department of Public Health here.

Hodne suggests that “if you need help preparing your advance directives or if you would like more information, contact your legal counsel, healthcare provider, or any hospital, hospice, home health agency, or long-term care facility.” Hodne reminds everyone that “planning is the key to protecting your rights!”

Importance of Advance Directives for End-of-Life Medical Care

comforting an elderly lady

Do your loved ones and medical providers know what type of medical treatment you prefer? By planning ahead, you can get the medical care you want, avoid unnecessary suffering, and relieve caregivers of decision-making burdens during moments of crisis or grief. You can also help reduce confusion or disagreement about the choices you would want people to make on your behalf.

An advanced directive is a legal document that explains how you want medical decisions to be made if you cannot make the decisions yourself. This directive lets your healthcare team and loved ones know what kind of health care you want or who you want to make decisions for you when you can’t. An advance directive can help you think ahead about what kind of care you want to receive as well as help guide your loved ones and healthcare team in making clear decisions about your health care when you can’t do it yourself.

“Advance directives help you protect your right to make medical choices that can affect your life,” said Julie Hodne, R.N., Education Coordinator at Manning Regional Healthcare Center. “They help your family avoid the responsibility and stress of making difficult decisions on your behalf. Advance directives also help your physician by providing guidelines for your care.”

All patients have rights that include privacy, informed consent, information about your condition, and information about advance directives. Advance directives can protect these rights if you ever become mentally or physically unable to choose or communicate your wishes due to an injury or illness. Advance directives can also limit life-prolonging measures when there is little or no chance of recovery. For example, advance directives may help patients decide if they want cardiopulmonary resuscitation (CPR), artificial nutrition or hydration, intubation, ventilators, or dialysis. They can also address your feelings about pain control and comfort care.

Let your values be your guide when creating your advance directives. Consider what is important to you. That may include passing on without pain and suffering, being able to make your own decisions, leaving your family with good memories and not burdening them with difficult decisions, acting according to your religious beliefs, or to be with your loved ones at your time of passing. Discuss your feelings with your family, friends, physician, religious leader, or your lawyer to consider what is best for you.

Advance medical directives are most commonly in the form of a living will or a durable power of attorney for healthcare. Both documents allow you to give directions about your future medical care. To get a durable power of attorney for health care or a living will, you will need to complete a form available from the Iowa State Bar Association.

To receive the form in the mail, send a self-addressed, stamped envelope to:  Iowa State Bar Association, 625 E. Court Avenue, Des Moines, Iowa 50306, with the following information in the envelope: your full name, address, and date of birth. You can also print and download the selected form here.

Once you have the forms, put your wishes in writing and be as specific as possible. Review your advance directives with your family, friends, physician, and power of attorney (POA). You will need to sign and date your advance directives and have them witnessed and notarized.

Keep a copy in a safe and secure place and provide a copy to your physician to be kept as part of your medical records. Your Durable Power of Attorney for Healthcare will also need a copy. Give copies to a relative or friend who is likely to be notified in an emergency. Review your advance directives regularly and make changes when necessary. Inform you physician, family, and POA of any changes.

Another document to be considered for any individual who is frail and elderly or who has a chronic critical medical condition, or a terminal illness is the IPOST form. IPOST stands for the IOWA PHYSICIAN ORDERS for SCOPE OF TREATMENT. The original form is strongly encouraged to be accompanied by the person it is written for. You can discuss this with your medical provider and find more information about IPOST from the Iowa Department of Public Health here.

Hodne suggests that “if you need help preparing your advance directives or if you would like more information, contact your legal counsel, healthcare provider, or any hospital, hospice, home health agency, or long-term care facility.” Hodne reminds everyone that “planning is the key to protecting your rights!”