Life or death decision Life or death decision (April 01, 2005)

Senior Center offers class on advance health care directives
by Rebecca Guyon

With the battle over Terri Schiavo dominating the news, many people have become aware of the need for an advance health care directive, yet there are still misconceptions about what it is and how to get one.

Jill Moore has taught a class on advance health care directives for four years at the Senior Center. The class, titled "Talking It Over," not only goes over the process of filling out an advance health care directive but also helps participants think about what exactly they would want to happen to them if they were in an incapacitated state.

"The form asks people to make decisions on questions they haven't thought about much," Moore said. "One of the things the class does in the first three weeks is discuss all the different value systems we have and think of how these determine the decisions we make for ourselves."

The course also explains the different options available for care, such as hospice care, and has a specialist explain exactly how to fill out the form.

The two main parts to the advance health care directive are naming your Power of Attorney for Health Care and Instructions for Health Care. Your Power of Attorney for Health Care is the person who will make decisions about your medical care if you are incapacitated.

"It's important to pick a good agent who thinks they'll know what you'd choose," Moore said. "You want someone who has a good head on their shoulders so they can communicate with doctors, and someone who lives close by."

The second part of the form asks you to leave instructions for health care. In this section you may state your wishes for medical care, including if you want to be kept on life support and under what conditions.

"Many people are surprised by the level of detail that goes into the process," said Reed Scott, an estate attorney in Pleasanton. "There are a number of scenarios where you need to specify exactly what you want to have happen to you so that your document leaves no doubt."

After the form has been filled out, it must be notarized in order to be official. Moore said it is quite easy to change your advance health care directive if you decide to at a later date. All you have to do is fill out a new one and get it re-notarized.

Both Moore and Scott said the biggest misconception about advance health care directives is that young people do not need them.

"Typically young people have not done planning because they think they're immortal," Scott said. "Terri Schiavo was in her 20s when she became incapacitated, and most of the other cases where you have prolonged life are with young people. A young person may have a debilitating accident but is still physically fit even if his brain is not working. It may take a long time for him to die, especially if he is receiving nutrition artificially."

Parents are responsible for making health care decisions until a person is 18 years old, but once that threshold is crossed health care wishes need to be put in writing ahead of time, according to Moore.

Moore said many people in the class make their health care decisions based on questions of quality of life.

"By far most people do not want to have life sustaining procedures because they don't want to be in a vegetable state," Moore said. "It always comes down to wanting to live out your whole life with dignity."

Scott said that while the majority of his clients also reject the use of life sustaining procedures, there are some people with religious beliefs that think the sanctity of life overrides everything and choose to have their life prolonged even if they are in pain.

"My job as an advocate is to ensure that their wishes are followed no matter what those wishes are," Scott said.

Currently, Moore is finishing teaching this winter's class, but expects another one to begin in the fall at the Senior Center. The class meets from 10 to 11:30 a.m. for six Thursdays in a row. Anyone in the community can attend, but space is limited to 10 people in order to keep the class personal. The class costs $25 for Pleasanton residents and $28 for non-Pleasanton residents. The cost includes a resource book and a completed, notarized copy of your own advance health care directive.

Anyone can get a copy of the advance health care directive form from the Senior Center for $2 or order it from the California Medical Association Web site at www.cmanet.org for $5.

"It is such a gift for a person to give to themselves and to loved ones," Moore said. "It can avoid lots of family arguments just by putting it in writing so everyone knows what you want."
'Talking It Over'

Next session is scheduled for the fall. Class meets at 10 a.m. for six Thursdays at the Senior Center. Cost is $25 for Pleasanton residents and $28 for non-Pleasanton residents. To sign up, call Jill Moore at the Senior Center, 931-5369.

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