Entrust advocate with end-of-life desires

Q. If I am unable to speak for myself when health care decisions are needed, what steps must I take now to be certain my wishes are followed?

A. The first steps can be remembered as the two T’s.

“Trust someone else with the responsibility of being your voice, should you need one, and tell them your wishes,” chaplain Bill Whalen of Olympia told EndNotes.

Talking candidly about end-of-life desires is a tough conversation, but necessary if you want your wishes followed. So, be specific. Do you want to be put on a ventilator? If so, under what conditions and for how long?

If your kidneys fail, is dialysis an acceptable option? What about a feeding tube?

After talking with your designated agent – your trusted advocate – document his or her name and contact information in a “durable power of attorney for health care” form. This document is not a power of attorney for your financial affairs, but for health care decisions only. You can obtain this form at your local hospital, because hospitals are legally required to have them.

The durable power of attorney for health care is one kind of an advance directive and is legally binding. The person you designate to speak for you has ultimate decision-making authority. The second kind of advance directive, a living will, states your desire to die a natural death and not use disproportionate medical interventions. Many people have both documents.

Make copies of your completed documents and tell your family where they are. If you are admitted to a hospital for any reason, bring the documents with you. If you live in different states throughout the year, complete one document from each state naming the same designee.

“The durable power of attorney for health care is the gold standard,” Whalen said. “And perhaps its greatest value is that it starts the conversation, directing someone to do something before it is needed.”

Q. Our 3-year-old asked my husband – whose father died before my daughter was born – “where did your daddy go?” How do I help her understand what it means that someone is dead?

A. Donna Killoughey Bird lost her husband in the Sept. 11 attack. Her children were teens at the time, but the former elementary school teacher believes that, no matter the age of the child, honesty works best.

“Even with a 3-year-old, speak from the heart. She will know you are being honest,” Bird, author of “Nothing Will Separate Us” told EndNotes.

In simple language, explain that daddy’s daddy is gone from Earth and won’t come back. Saying he is asleep or has taken a trip somewhere will confuse a young child about the true nature of death.

This could worry your daughter, because when mom and dad travel or fall asleep, does it mean they are dead?

Explain what you believe happened to the spirit of her grandfather, according to your own beliefs. Bird believes that her husband’s spirit watches over them and sometimes sends signs, such as beautiful birds that appear in beautiful places. She intends to share that mystical belief with her future grandchildren.

Your daughter might also fear that her loved ones will die soon, just as grandpa did, so assure her that loving adults will always surround her.

When Bird’s husband died, she told her children, “I don’t know what is going to happen to me tomorrow, but I am going to do everything I can to be around.”

Sharing photos and memories of your daughter’s grandfather will help shift the topic off the mechanics of death, which might overwhelm her if you go into too much detail.

Bird said that while showing the pictures you can say, “Memories are what he left us.”

And those can last forever.

Catherine Johnston, a health care professional from Olympia, and Rebecca Nappi, Spokesman-Review features writer, welcome your questions about what to do in times of illness, dying, death and grief. Contact them through their EndNotes blog at www.spokesman.com/ blogs/endnotes.

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