End of Life Concerns

Although we all understand that the end of life is inevitable, it is a topic that many people feel uncomfortable thinking about or discussing. The type and timing of decisions surrounding end of life issues varies based on an individual’s personality, age, health status, cultural influences, access to medical care and professional resources, family dynamics, religious beliefs, and a host of other factors. Some individuals may be given a time frame for the expected end of life, such as when receiving a diagnosis of cancer; others will have no idea.

There are some steps that can be taken by adults of any age to ensure that autonomy will be respected whenever the end of life occurs. Most people would agree that they would not want strangers making decisions for them during this critical time. In order to prevent this situation from occurring, legal documents addressing decision making for both health related issues and legal/financial concerns should be drafted. These documents are called Powers of Attorney. In addition, a document called an Advance Care Directive (or Living Will) can specify the type of treatment you desire if you should be in an end stage terminal medical condition or permanently unconscious, and unable to voice your preferences at that time. For additional information about these documents, click here.

Another type of document used to communicate an individual’s preferences for end of life care is called POLST (Pennsylvania Orders for Life Sustaining Treatment). This form is a medical form that must be completed by the individual and his physician. The POLST form is appropriate for individuals who are experiencing chronic progressive illness and/or frailty, or those who may die or lose decision-making ability within the next year. POLST is a bright pink form that is standardized across the entire state, and specifies medical orders for treatment such as cardiopulmonary resuscitation, artificially administered hydration/nutrition, antibiotics, and mechanical ventilation. It is different from, and is not meant to replace, an Advance Care Directive or Health Care Power of Attorney. These types of documents work best when a Health Care Power of Attorney Agent has been designated to assist in decision-making when the individual is unable to speak for himself. An individual should ALWAYS discuss his wishes related to medical treatment with his Power of Attorney Agent, so that the agent has an accurate understanding of and can act in accordance with the wishes of the individual.

Whether or not treatment wishes are clear, when a loved one’s end of life is near, families often wrestle with conflicting emotions and lack of knowledge about the process of continuing or withdrawing treatment. Keystone Elder Law has a Care Coordinator on staff who has training and experience with these types of issues, and can help advocate for the client and guide and support family members during this difficult time. Assistance with understanding what to expect, communicating with care providers, initiation of hospice services, and the process of estate administration are just some of the services Keystone Elder Law can provide to help families handle essential tasks while they are experiencing the grieving process.

For additional information or questions, give us a call at 717-697-3223.