Welcome to the Light Keepers Podcast. I'm Clayton
Vandiver, your Light Keeper, with a show dedicated
to everyone who wants to get the most quality
out of life that they can. My co -host as always,
Charlene, our licensed clinical social worker
in the state of Florida, joining the conversation
this week about people who don't quite get the
whole picture. And so much more on this edition
of the Light Keepers Podcast. And before we start,
please leave your questions or comments below.
We love to hear from you. Questions this week
will be answered during our show that appears
online every Wednesday evening at 7 p .m. Eastern,
both audio and on YouTube. The Light Keepers
Podcast is an exclusive production of A Guiding
Light. We'll tell you more about that great organization
at the end of the podcast. But we don't have
much time. Let's get right into this week's conversation
about people who don't have the whole picture.
Charlene, what in the world are we talking about?
So we're talking about well -meaning individuals
or organizations who host events where people
can come and get information about their advanced
directives. Okay, like the Five Wishes? Like
the Five Wishes. Okay. But these events are being
hosted by people who don't have any medical training.
Their intentions are good. They are trying to
do the right thing, but they may not be showing
the full picture. I see. So when you get the
five wishes, and I wish we had one of those documents
in front of us right now. Are you familiar enough
with it to tell us what the five wishes are?
Oh, absolutely. Absolutely. I may not get them
in the right order, but I can tell you what.
And first of all, the five wishes is a little
deceptive because it's not about five wishes.
There are actually only three. Well, for folks
who don't. have never heard of the Five Wishes
before. Tell us what that's all about. So the
Five Wishes is an advance directive that is legally
binding in almost all 50 states. I think last
time I checked it was legally binding in 46 or
47. And just to break it down for those who really
aren't familiar with it, what's an advance directive?
An advance directive is a document that outlines
the type of medical treatment that you would
want if you were to become seriously ill and
no longer able to make your own medical decisions.
Ah, so when communication fails or mental capacity
fails, you're unable to make decisions. Or if
you're injured and unconscious. Unconscious.
Okay, so... Communication has failed. The ability
to tell the doctors what you want done or not
done is no longer possible, but the five wishes
can speak for you. Absolutely. Any advanced directive,
and an advanced directive usually consists of
two parts. A living will, not to be confused
with a last will and testament. Last will and
testament, property and finances. Living will,
medical and health. Ah, well, there you go. We
may have to do a whole show about that. And we
might speak with an elder care attorney or someone
who really knows those wills inside. Of course,
you know them inside and out, but they might
know some nuances that we can share with the
audience. They know the legal side, but even
they might not be able to provide the medical
guidance that can be very helpful. when talking
about the advanced directive, the living will.
Absolutely. But that's exactly what we're talking
about is how some people, elder law attorneys,
churches, seniors groups. Good point. These are
places who oftentimes encourage people to be
prepared by having their documents in order,
but they may not be able to provide the ins and
outs of. getting that document in order. And
when they're well -meaning, they're intending
best for their parishioners or their community
members who come in, but they don't necessarily
have the training, the knowledge, the expertise
to nuance all of those other things. Now, what
else besides the five wishes? Oh, we were going
to say what the five wishes were. So the five
wishes consist of identifying your values in
life, the things that are important to you. When
I talk to people about the things that are important
to them, how they define that good quality of
life, most of the time what comes out is, I don't
want to be confined to a bed. So bedridden apparently
is a big deal, but that's just an example of
what they mean by value, quality of life statement.
So you want to talk about your values. You want
to talk about... who you trust to make those
decisions for you. And then you get down to the
three wishes that are specifically about your
medical treatment. And those usually, like with
the five wishes, it's would you want to be maintained
on life support if you were nearing the end of
your life, if you were permanently unconscious,
or if you were in a state of permanent confusion.
So in a nutshell, Terminally ill, coma, dementia.
I mean, that pretty much sums it up right down
the line. Now, the five wishes is not the only
advance directive out there. A lot of states
have their own documents. It doesn't have to
be super specific. You can go online and download
one. The key thing is you want to make sure that
it's witnessed and notarized. That's what makes
it official. That's an important step. I wonder
if when those communities or parishes have those
gatherings and talk about doing that, I wonder
if they finalize that step or just send folks
home saying, take this to your local bank or
savings and loan and have them notarize it for
you. And then it gets misfiled, never gets finalized.
That can happen. But the more important part
of that is, you know, a lot of times these organizations,
these communities, they're providing this document
so that people can be more prepared or maybe
to at least start the conversation. Because it's
a difficult conversation that some people find
uncomfortable. Nobody likes to talk about it.
But it is important to talk about because otherwise
nobody's going to know what you would want. But
the problem is, is these are people that might
not have the medical training. to be able to
answer the questions that might come up. So for
example, what is life support? Do you know what
life support is? Not the technical definition.
When I think life support, I think of a lot of
tubes and wires and a hospital bed. And I see
a lot of things happening, but not usually with
the patient themselves. They're usually out at
that point. Right. So if someone were to say
to you, Would you want life support if you were
in a coma? Would you even know what you're saying
yes or no to? Well, it would help to have a medical
expert or social worker there who could define
the terms. Exactly. It's hard to make any real
decision in life. And I know the attorneys out
there will be nodding their heads right now because
the English language is very important to their
trade. That if you don't define the terms. You
don't know what you're agreeing to. Exactly.
Even about yourself. Exactly. And considering
the fact that this is medical treatment that
could save your life or prolong your life in
a condition that you would not want to live in.
In other words, you're able to more take control
of, as this is what we're all about, is letting
people live their lives with more control over
the choices. and the quality of life that they're
enjoying at any stage in life, not just at the
end of life or not just when you're on a life
support, but anytime. If you have the knowledge
to make good decisions along the way, you make
better decisions. That's what the show is all
about. Absolutely. And it can be a simple thing.
It can be a simple thing. I was speaking to someone
the other day who had a relative who went in
for a simple joint replacement surgery. And while
under anesthesia, had a stroke. Oh, wow. Okay,
so we're talking simple procedure, minimal risk,
catastrophic outcome. And had that individual
not had advanced directives, the family wouldn't
have known what to do. I understand. Well, when
these community centers or churches have these
meetings and... And have these folks go home
thinking they're all covered, they're all set,
they're all ready, they have everything they
need. And what else could they possibly be getting
that they're missing out on? What other advanced
directives, if you will? As infinite as the World
Wide Web is, so are the documents that you could
download and complete. Wow. For example... Because
I know every day you're filling out documents
for patients that... have a lot more complexity
than just those basic three or five wishes. Very
true. Very true. In some states, there is a document
called a post, which is a physician order for
sustaining treatment. And for some states, that
is their version of a do not resuscitate form,
which is what you want when you do not want them
to do CPR on you. So in Florida, it's a do not
resuscitate. in some states it's a post physician
order for sustaining treatment and the post actually
goes into a lot more detail for example beyond
whether or not you would want to be resuscitated
it will also ask what level of care do you want
if you're hospitalized do you want comfort only
Are you willing to accept selective treatment,
which usually includes antibiotics or IV hydration?
Oh, there are a lot of choices. Or do you want
everything, which includes ICU, ventilator, feeding
tube, all that yucky stuff? Well, you see, folks
who didn't have that technical knowledge wouldn't
even know to ask those questions and certainly
wouldn't have forms in front of them for you
to fill out. So it isn't that those... community
or or institute religious institution -based
meetings civic organizations it's not that you
shouldn't do that but if you do that you may
want to consider seeking out some more information
and some more forms and maybe finding out if
that is everything that you might want and to
find that out who's the best person to go to
so what i would strongly recommend is reaching
out to a local hospice or a local hospital and
asking. Some hospitals have their own advance
directive that only applies for that hospital.
So a hospice might be a better route to go in
that case. If you want to just keep it simple,
look online at the Five Wishes website. See if
you're one of the 40 some odd states that it
covers. There are other booklets out there. For
example, in Florida, there's also the Honoring
Choices booklet, which is good. My professional
opinion is it asks too many questions. tries
to go into a little too much detail. Could be
overly complex. I can't imagine a government
agency providing anything that's overly complex.
So the Five Wishes is very simple, and more importantly...
Is that a political statement? We don't go there.
Okay. But the Five Wishes is a good document
because it's clear, it's simple, but even in
its simplicity... there can be questions that
unless you have that medical background, you
may not be able to answer. So what I would recommend
to these religious organizations or civic groups,
anybody who's planning on hosting an event like
that, beyond researching the document, contact
your local hospice or your local hospital and
ask them if they have a social worker that can
come out and maybe sit at the event to answer
questions. Oh, that's a great idea. Provide a
little bit of professional insight and someone
there just to answer questions if people have
them. Absolutely. And perhaps even to provide
a few documents that may go above and beyond
if someone wants that. Absolutely. Of course,
this is all a highly personal choice. No conversation
that we have on the Light Keepers podcast should
ever take the place of your own medical care
team or other medical professional advisor who
should always be consulted by you on your specific
situational needs. It's always good to be willing
to talk about quality of life because, well,
every single one of us will face some of these
issues someday. And you may either not be prepared
at all or very well prepared indeed for joining
us here right here on the Light Keepers podcast
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