Advance Directives: Thy Will Be Done

April 19, 2016

Written by Kimberly Sussewell, BSN, RN, Clinical Educator

No one likes talking about dying or what kind of care they would like to have if they become unable to make medical decisions. However, it is important to have the discussion about Advance Directives to help honor your wishes and to offer peace of mind to you and your loved ones.

Advance Directives are the legal documents that contain instructions for future medical care in the event that a person loses the ability to make or communicate a healthcare decision.

In the absence of these documents, family members are called on to make medical decisions for the patient. This is extremely stressful for the patient's loved ones. When family members disagree about how to proceed with treatment, a lack of Advance Directives causes even more friction. 

Studies have shown that only 18% to 30% of Americans have written Advance Directives. This low percentage is largely due to a lack of knowledge about the approved documents and the presumption that there is always time to talk with family members.

Providence Health’s Advance Directives completion rate is approximately 10% (varying by floor and area). This means that only 1 out of 10 patients have a document that makes their healthcare wishes clear.

Here's what we can do to help improve these numbers. First of all, complete your own Advance Directives, if you have not yet done so. Become familiar with the different types of documents recognized in the state of South Carolina. 

Talk to your friends and relatives about their wishes. Explain how completing Advance Directives helps to ensure that their wishes are carried out AND prevents additional family stress around the time that such decisions need to be made. 

When discussing health care preferences with someone, consider the following questions:

  • What’s important to you if faced with a life-threatening illness or injury?
     
  • How much decision making power do you and your family want versus your healthcare providers?
     
  • What treatments would you definitely like to have pursued on your behalf?
     
  • What treatments, if any, would you NOT like to receive?
     
  • Would you want to be fed and hydrated if you were in an irreversible coma?
     

Advance Directives do not mean you cannot be treated. Quite the opposite -- they ensure that the patient gets treated exactly as he/she wishes to be treated. Patients can specify very aggressive or very minimal treatment in the documents. Also, Advanced Directives are not a substitute for patient discussion with a physician or palliative care member; they are simply an additional asset.

Yes, talking about death and dying is difficult. But having this difficult conversation now will help avoid far greater discomfort down the road.

Kim Sussewell Advanced Directives

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Kimberly Sussewell, RN, BSN, is a Clinical Educator at Providence Hospitals in Columbia, South Carolina. She earned a Bachelor of Science Degree in Nursing from the University of South Carolina, Aiken.  Kim has 20 years of Nursing Experience in Cardiac, Medical/Surgical, and Orthopedic Service Lines. She also served as a Palliative Care/Hospice Nurse who supports Advanced Directives and honors patients’ rights to make medical decisions.