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March 17, 2010 > Make Your Wishes Known

Make Your Wishes Known

Dispelling Myths About Advance Health Care Directives, End-of Life Care

What if you became ill or injured and could no longer communicate with family members or health care personnel to let them know your wishes and what kind of care you would like?

By completing a document called an advance health care directive, you can make your wishes known, letting your physician, family and friends know your preferences, including the types of special treatment you want or don't want at the end of life, your desire for diagnostic testing, surgical procedures, cardiopulmonary resuscitation and organ donation.

Next Tuesday, March 23, Father Jeff Finley, Spiritual Care Coordinator for Washington Hospital, and Dr. Mohamad Rajabally, a Fremont dentist and former president of the Islamic Society of Alameda County, will present a free Health & Wellness seminar at Washington Hospital focusing on the importance of letting your wishes - spiritual and health care - be known.

They will be joined by Ellen Cuozzo, R.N., CHPN, East Bay Community Relations Manager for Pathways Home Health, Hospice and Private Duty, who will discuss Physician Orders for Life-Sustaining Treatment (POLST) Paradigm program.

"When I did this talk before, there were lots of people calling and wanting one-on-one consultant and saying the discussion about advance directives was a real eye-opener," Father Finley says. "This time around, I've asked one of our Muslim chaplains to present with me in order to reach out to Middle Eastern members of our community and expand awareness by having someone from that represents the Islamic community share from his point of view.

"Dr. Rajabally is a dentist by trade, a scholar and a preacher. He's very aware that people in the Muslim community are not doing advance directives and he would like to help change that."

Father Finley says he wants to spread awareness of advance directives to all cultures in Washington Township and dispel any myths.

"The purpose of advance directives is to give you the opportunity to sit down with your family members and write down what you want in terms of end-of-life care," he says. "An advance directive is literally about honoring your wishes. As a health care institution, we have to honor your wishes above anything else. And if your wishes are written in a legal document, we are bound to honor those wishes.

"An advance health care directive is about protecting the patient and honoring what they want."

Emotionally, discussing end-of-life wishes with family members, especially adult children, can be difficult. And in many cultures, family members don't talk about issues like these, Father Finley says.

"When you approach different cultures, the decision maker is often the oldest son and they often are forced to make end-of-life health care decisions for a parent when they don't know what that parent really wants," he points out. "And when they don't know the wishes of the parent, then they are going to do everything because they don't want to let their parent go."

The advance directive document ensures that end-of-life wishes will be carried out exactly as the patient intended, which is why Father Finley recommends that every adult fill one out while they are of sound mind and body.

"In the hospital setting, it gives us something to work with if the patient is ill but still conscious; or if the patient is unconscious, it tells us what they would want," he says. "This document is not about making money or ending someone's life. It is a decision you have made yourself once you've discussed it with family members and your appointed decision maker."

Importantly, if you change your mind about any of the decisions you made in your advance directive, you can fill out a new one, which becomes the new binding document.

"Our goal is to get rid of some of the myths and help people understand that it's about honoring the patient's decisions whether they want everything or nothing or some in terms of end-of-life care," Father Finley says.

The document that Father Finley and Dr. Rajabally will be discussing is called the Five Wishes, which goes beyond an individual's health care wishes to include:
* Who you want to make health care decisions for you if you can't make them.
* The kind of medical treatment you want or don't want.
* How comfortable you want to be.
* How you want people to treat you.
* What you want your loved ones to know.

"This document goes more to the heart of the person and allows people to be part of the process," Father Finley says. "It's more of spiritual document in the sense that it addresses the whole person."

Ellen Cuozzo, R.N., Certified Hospice & Palliative Nurse (CHPN), East Bay Community Relations Manager for Pathways Home Health, Hospice and Private Duty, will follow with a discussion about POLST, a program specifically designed to improve the quality of care people receive at the end of life.

Based on effective communication of patient wishes, it includes documentation of medical orders on a brightly colored form with a promise by health care professionals to honor these wishes.

"In my experience, there are times when a patient feels compelled to continue with burdensome treatments in spite of their own wishes," Cuozzo says. "I would like to share how health care decisions based an individual's desires for themselves are often the best. It is difficult, yet very important, to have the 'What do you want?' conversation with our family members regarding end-of-life care."

Like POLST and advance directives, the entire design of hospice care revolves around a commitment to the patient's wishes and dignity above all else.

"Hospice is a resource for people with a life-limiting illness that want to make the best of what time is left when there are no options for aggressive treatment or cure, as is the case of certain types of cancer, heart disease, liver failure, organ failure or simply general health decline. It is also an option for those that just don't wish to seek aggressive means of treatment."

"Hospice is a choice for people who want to make the quality of their lives the best it can be."

To learn more about advance health directives and the POLST program, join Father Finley, Dr. Mohamad Rajabally and Ellen Cuozzo for their discussion on Tuesday, March 23, from 1 to 2:30 p.m. in the Conrad E. Anderson Auditorium, located at 2500 Mowry Avenue in Fremont.

To register, visit and click "Register Online for Upcoming Seminars" at the bottom of the page or call (800) 963-7070.

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