After rushing his wife to a hospital emergency room with what turned out to be a blood clot in her heart, Haag repeatedly had to restrain intensive care unit doctors and technicians who wanted to connect her to a dialysis machine and a respirator. The first step is to have that talk with the family and let all the disagreements and arguments occur while you're still healthy and can participate. It's not enough to say that you don't want everything done to keep you going, says Joan Teno, a Brown University geriatrics specialist and co-author of a landmark study underscoring how seldom advance directives or living wills are honored. You have to give some advice about what you value and when decisions should be made. It can be as full of anxiety as discussing sex with a teenager.
Many groups offer a number of tools and checklists to help guide and prompt conversations.
The form probes how people feel about religion, self-sufficiency and health problems as well as fears, finances and more. It's intended to be filled out before writing a living will, to provide a context in which health-care decisions can be made. Other counselors insist that a written document helps avoid conflict in a grieving family. Most advocates urge people to give at least one copy to their regular doctor and to their health-care surrogate and to a backup person. If some aspect of treatment particularly worries you, it should be specifically discussed in an advance directive.