What Do I Have To Do?

Complete the Forms

Whether you use the Five Wishes © form (www.agingwithdignity.org) that Munson supplies or one prepared by your attorney, it can be helpful to your Health Care Agent if you put some of your wishes in your own words. Some statements people have personalized include:

• I do not want to be in pain. I want to have enough medication to relieve my pain, even if it means I will sleep more than usual.
• I want to die in my home.
• I want to be referred to hospice earlier rather than later.
• I want to donate tissue or organs to the Gift of Life.
• I want to have my favorite music played, even if I seem unresponsive.
• I wish to have daily prayers said at my bedside.
• I want friends and relatives to visit, hold my hand, and talk to me about the daily lives of their families.
• I have spoken with my Health Care Agent about the things I want and don’t want, and I want you to respect them by honoring my wishes.

Munson Medical Center has copies of Five Wishes © that are specifically adapted to meet the legal requirements of the State of Michigan. If you have questions about Five Wishes, please contact Munson's Advance Care Planning at (231) 935-6176 or advancecareplanning@mhc.net.

Other types of directives can be found at the following links:

• Caring Connections
• Planning for your... Peace of Mind
• Guidelines for End of Life Decisions

Necessary Signatures

• Be sure to sign your form in front of two witnesses. To be valid, your witnesses must not be someone who will inherit from you or an owner or employee of a health or residential care facility serving you.
• Be sure to have your Health Care Agent sign their acceptance of this role on your form. In the Five Wishes © form, this can be found on page 11.

Copies of Your Form
Keep the original of your advance directive. Make copies for:

• The person you have chosen to make decisions for you
• Your physician(s)
• The hospital to which you are most likely to be admitted

Electronic Retrieval
Many people use the Internet to store and retrieve their advance directives. You may want to investigate this further by visiting:

• MedNotice
• U.S. Living Will Registry

Using an Advance Directive
When actively facing end-of-life decisions, you should:

• Recognize that the dying process is complex. Unexpected medical, emotional, spiritual, and practical issues will arise.
• Talk to your physician about end-of-life care views held by you or your loved one.
• Talk to your loved ones about your views on end-of-life care. If you are the Health Care Agent, talk to your loved one’s inner circle about his or her views of end-of-life care.
• Make sure the advance directive is in your medical record (chart).
• Discuss how different medical treatments fit with goals for living well until death. Will a proposed treatment help you get to your goals? Or, will it further compromise your quality of life?
• Remember that the benefits of a treatment may change as an illness progresses, and it is both legally and ethically permitted to stop treatments if they no longer meet your loved one’s goals.
• Be aware that intense feelings and family problems can make it difficult to talk about these issues.
• Make use of resources such as hospital chaplains or social workers.
• Be sure to make decisions based on your loved one’s views, whether you fully agree or not.

Many questions need to be asked to help understand the patient’s medical condition and what comes next:

• Is it still possible to cure her/his disease or illness?
• If no cure is possible, what are the chances she/he can at least improve?
• Given her/his current condition, what do you expect in the next few weeks? In the next few months?
• Are other medical problems likely to arise?
• What are the treatment options?
• What would happen if we didn’t do the proposed treatment?

You may ask for a patient care conference if your physician’s views do not agree with those held by you or your loved one. If the differences are not resolved after discussing them, request assistance from the Ethics Committee at your hospital.

You can expect your physician to:

• Be willing to discuss advance care planning
• Give you time to talk about your concerns
• Ask about and respect your values and decisions
• Provide clear and complete information
• Make sure that you understand important information
• Discuss future decisions, giving you time to consider and plan
• Discuss treatment options, including comfort care
• Encourage decisions that all can accept
• Provide time for you to consider different treatments
• Involve you and your family in developing your plan of care
• Involve social services and/or hospice for emotional and practical support, including financial concerns
• Enlist the help of the chaplain or other resources to offer spiritual support
• Provide comfort care to you and your family
• Make sure you and your family know what to expect in the dying process
• Consider the needs of both you and your family as part of comfort care
• Ensure effective pain relief and symptom control
• Discuss hospice services

If you are a Munson Healthcare patient and have a compliment, concern, or complaint, please contact one of our Patient Liaisons.

We welcome your comments and suggestions about this Web site.