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Commentary: Planning for afterlife is a gift

Matt Pommer

We found our 85-year-old neighbor Claude dead on his kitchen floor with his tiny pet parrot perched on his shoulder. He was wearing a bracelet that indicated he did not want to be resuscitated.

Claude’s physician had talked with him about end-of-life options. Claude said he wanted to die at home in his bed. The physician said “at home” was manageable, but there was no guarantee about being in bed.

End-of-life topics are back in the news in the wake of congressional suggestions to provide Medicare payments in an effort to encourage health providers to discuss such issues with their patients.

Conservatives, led by Sarah Palin, have pictured this leading to euthanasia or “death panels” of physicians who refuse care to the elderly.

The state Medical Society, the Wisconsin Hospital Association Inc. and the State Bar of Wisconsin addressed the issues years ago with a booklet entitled “A Gift to Your Family.” It focuses on planning ahead for future health needs. The booklet is available free in most physician offices, clinics and hospitals.

The organizations urge people to provide either a “power of attorney for health care” or a “declaration to physicians,” aka a living will, while they are competent. The power of attorney includes a description of treatment preferences to guide the agent.

Issues include use of feeding tubes, surgery except to reduce or ease pain, avoiding radiation or chemotherapy except to reduce pain, kidney dialysis, and erring on the side of over medicating even if it increases death risks.

It provides guidance about terminal conditions, persistent vegetative states and advanced dementia.

Delegating the authority, perhaps with guidelines, makes it easier on families that disagree on what should be done for seniors when a health emergency strikes. Having one person in charge eases disagreements.

Not all elderly have families with whom to discuss such matters. Physicians often are the educators. The proposed Medicare language would have provided some payment — and thus incentive — for them to help seniors with such planning.

But the idea seems gone from the health care reform debate. You can help by getting the “A Gift to Your Family” booklet and discussing it with your family.

Matt Pommer worked as a reporter in Madison for 35 years. He comments on state political and policy issues.

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