Monday Medical: Communicate your health care choices

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Advance directive forms are available at Yampa Valley Medical Center, Northwest Colorado Visiting Nurse Association and local physician offices. They may be downloaded from the hospital's Web site, www.yvmc.org. Other helpful web sites are: www.helpstartsher... and www.caringinfo.or...>

— A healthy, vibrant woman, age 75, was golfing when she suddenly fell to the ground. Diagnostic tests revealed an aggressive type of brain cancer. A delicate surgery was recommended.

Another woman, just 38 years old, was struggling to control her diabetes. One day at home she collapsed in cardiac arrest and suffered significant brain damage. Physicians did not expect her to make a meaningful recovery.

These real-life examples come to mind when members of Yampa Valley Medical Center's Ethics Committee discuss the importance of making and communicating one's health care choices in advance.

The older woman was able to give her family peace of mind by choosing her course of treatment and manner of death. It was a different story for the younger woman's family, who spent many agonized hours debating what kind of care she would have wanted.

Thursday is National Healthcare Decisions Day. YVMC's Ethics Committee advises everyone to prepare for an unexpected and serious health challenge.

"Sometimes people can go from being very able to speak for themselves to not being able to, within 24 hours," Ethics Committee Chair Carole Milligan, M.D., said. "The message is: communicate, communicate, communicate. Don't delay discussing your medical wishes with friends and family."

The Ethics Committee serves as an advisory group and resource to YVMC and its patients. The committee helps to identify and address issues involving patients and their families in treatment care decisions.

Roberta Gill, a registered dietitian in Steamboat Springs, joined the committee after her 75-year-old mother died from brain cancer, less than two months after collapsing on the golf course.

"My mother got extensive information about her disease," Gill said. "Before her surgery, she wrote everything out for my brothers and me, including her funeral plans. She knew exactly what she wanted, and that made it very easy for us to follow her care wishes when the surgery didn't turn out well.

"There were no family arguments because they were all her decisions, not our decisions. Mom died peacefully and without pain."

National Healthcare Decisions Day is intended to raise awareness among individuals, physicians and other caregivers about the importance of putting one's care wishes in writing.

"People don't always want to look at what are primarily end-of-life decisions," Milligan said. "It's not easy to ask yourself, 'What if I am in an accident?' But you've got to consider this possibility and who would make your decisions for you."

Milligan lists three steps. The first is to think about what you would want in terms of medical care if you were unable to communicate. The next step is to fill out legal documents.

A living will puts your medical wishes in writing. A medical durable power of attorney includes a statement of personal desires concerning life-prolonging care, treatment, services and procedures. It also allows you to designate an agent or spokesperson.

"This could be a close friend or relative, but it cannot be your doctor," Milligan said. "It should be someone you trust to be strong and speak up for you, making decisions from your perspective, not their perspective."

Finally, you must make your wishes known to your spokesperson and provide a copy of your documents. Milligan advises giving copies of your documents to your physician, hospital, friends and family members.

"Let people know that you have an advance directive and where it is located," she said. "Do not keep it in a safe deposit box - make sure it is accessible."

Roberta Gill will be forever grateful to her mother for communicating her end-of-life wishes both verbally and in writing.

"This is the most generous act a person can do for their family," she said.

Christine McKelvie is public relations director at Yampa Valley Medical Center. She may be reached at christine.mckelvie@yvmc.org.

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