When catastrophes occur, it is young people without power of attorney documents who are often the subjects of terrible battles over their care. (E+ photo / December 6, 2013)
 
By Barbara Brotman
December 9, 2013
Would anyone like more pie?
If you were neurologically devastated in an accident, would you want to forgo life-sustaining treatment?
It wasn't exactly like that at our family's recent holiday dinner. But with our children home for a few days, we took the opportunity to engage in a nontraditional holiday activity:
Completing advance medical directives.
And it wasn't just my husband and me signing forms naming agents to make our medical decisions if we are unable to; our 22- and 25-year-old daughters did so, too.
The idea came from the lawyer drawing up our wills and advance directives. We had arranged to meet with him over the holidays so our daughters could be there. He told us they should complete several documents of their own — powers of attorney for health care and financial decisions in case they are ever unable to make them, and privacy releases directing hospitals to disclose medical information to us in an emergency.
And so in the days leading up to the meeting, and again around the dining room table, we talked about what we wanted to happen if we ended up in a coma or persistent vegetative state.
It may sound less than festive. But actually, because all parties are present, holidays are a fitting time to talk about and sign advance care directives, said Karen Nisley Long, president of the Chicago End-of-Life Care Coalition.
"It's a great thing to do when the family gets together," she said.
Dr. Julie Goldstein, medical director of the Palliative Care Consultation Service at Advocate Illinois Masonic Medical Center, will be spending part of the holidays talking with her own daughters, ages 18 and 20, as they complete their powers of attorney.
She is well-prepared. A trainer in Respecting Choices, an advance care planning program at Gundersen Health System in La Crosse, Wis., she teaches health care providers, including those within Advocate Health Care, how to lead these talks.
She plans to ask her daughters the same probing questions about their understanding of advance planning, their concerns and their wishes.
"I think our kids think about this stuff," she said.
Why ask healthy young people to make theoretical end-of-life decisions when they are statistically so far from the end of life?
Because catastrophes happen. And when they do, it is young people without such documents who have been the subjects of heartbreaking battles over their care, Long said.
"Karen Ann Quinlan; Nancy Cruzan; and of course most recently, Terri Schiavo," she said. "All the famous cases, really, had to do with young people, vibrant people who had long lives to look forward to."
Everyone over 18 should have a power of attorney for health care, she said.
If they don't and they become incapacitated and unable to make a medical decision, in Illinois a representative is appointed under the Health Care Surrogate Act. The act establishes a hierarchy of eight possible surrogates; a parent is fourth on the list.
But a power of attorney — which is widely available online and can be completed without a lawyer — is preferable, said Long, who in addition to her end-of-life coalition role is director of development at Horizon Hospice & Palliative Care. A surrogate ends up being picked by chance, depending on who can be reached first by phone in an emergency, she said. And the surrogate is often taken unawares, asked to make a profound decision with no idea of what the now-unconscious person might have wanted.
The point of the power of attorney form, she said, "is that it starts the conversation."