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Holvino: Advance Health Care Directives

After much procrastination, my husband and I completed our Advance Directives – just before witnessing my cousins scramble to make decisions about my aunt’s end of life as she lay in a coma in a hospital in San Juan. I remember thinking how grateful I was to have my directive on file with my doctor, my hospital and the Vermont Registry.

While ninety percent of Americans have heard about Advanced Directives and seventy one percent have thought of doing them, only twenty five percent have actually completed them.

In a culture that prides itself on the right to make individual choices, it’s hard to understand why so many leave this most important decision about life and death to an impersonal medical system.

My advance directive names my husband as my health agent and instructs him to allow for natural death as much as possible. In preparation, we had conversations about what kind of care we want and don’t want and what’s important for us up to those last moments of life. We even included what we want after death: true to our differences, he wants a party for all his friends and I want an ecumenical service where the Hallowell Singers, from our hospice organization in town, sing.

There are many resources available to help us complete our advanced directives.

In Brattleboro, trained volunteers will even help you fill out the forms at home. I also found that watching some videos and playing a card game helped me think through my end of life wishes. And while an advance directive can’t solve all the problems of end of life, it offers protection from the potential pressures of the medical system to do more - and relieves my family from having to guess my wishes at the last minute. Of course, if I change my mind I can always revise my directive.

National Health Care Decisions Week invites everyone to discuss, agree-on and document our wishes for end of life care. I’m glad my husband and I did because it will help us and our health providers honor our wishes. And I’ll admit, it’s a big relief to know that we’re done with one more of life’s most important tasks.

Evangelina Holvino is a creative non-fiction writer and a free-lance consultant on issues of social differences and justice in non-profit organizations.
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