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Guest commentary / Advance directives

Don't put off important health-care decisions

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By Peg Rutchik and Lori Hermansen
April 16 is the fifth annual National Healthcare Decisions Day. The focus of this day is to think about and document our wishes related to health-care provision.
Called "advance directives," these legal documents provide written instructions to guide your family, physician and other health-care providers on your wishes at times when you are either too ill or hurt to express them yourself. There are no right or wrong answers -- just your wishes.
But how does one start the conversation? Many people sit down and fill out the forms as a family. If someone is facing a significant illness, having that conversation earlier rather than later is best. Involving your physician in the discussion can aid your understanding of the options for treatment.
Talking isn't enough. We must write down our decisions.
There are several types of advance directives: living wills, physician orders for life-sustaining treatment (POLST) forms, "Five Wishes" and durable powers of attorney for health care (DPOA).
The POLST form is a common form used in Washington state. Any time a person is admitted to a hospital or nursing home, he or she is asked to complete the POLST form. The Five Wishes form is legal in Washington and in many other states. When used, it helps guide families through these same issues. A DPOA form is used to select a person you trust to make health care decisions for you when you are unable to do so.
The National Healthcare Decisions Day website at offers free information, forms and tools to help make health-care choices. The Patient Self-Determination Act of 1990 gives each of us the ability to tell our health-care providers and our loved ones what we want.
Yet most people haven't taken action. According to a study by the U.S. Agency for Healthcare Research and Quality, fewer than 50 percent of severely or terminally ill patients had an advance directive in their medical record. And between 65 percent and 76 percent of physicians whose patients had an advance directive were not aware that it existed.
Those numbers are surprising, given the fact that Five Wishes, POLST forms and durable powers of attorney can be completed without an attorney, cost nothing and are relatively easy to do.
An advance directive will help those around you know what types of care you want. Take the time to write down your wishes and be sure to share the documents you use with your family and health-care provider.

Peg Rutchik is vice president of hospice services with Providence Hospice and Palliative Care. Lori Hermansen is director of Providence Hospice of Snohomish County. For more information go to

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