Dear Family and Select Friends,
This supplementary letter to my Advanced Healthcare Directive (AHD) is to ensure that my wishes will, to the utmost extent possible, be honored as it pertains to my long-term healthcare.
I hope that I’ve been clear over the years in talking (ad nauseam) to family and friends about my personal convictions. The instructions in my AHD are well-defined enough I hope. To recap, I do not want to be treated for any terminal health incidence, whether physical or cognitive, that may unnaturally prolong my life. Basically, any health-related episode that impacts my ability to care or make decisions for myself is not one I choose to continue. Comfort care only. No hospitals. No resuscitation. No medical procedures that may prolong my life.
If by the time this letter may become relevant my preferred exit strategy – a glass of Merlot, a dark chocolate truffle, and “pink pill” to the other side – is not an option, I ask that my advocate(s) please begin hospice care at the earliest feasible time. If it is possible to keep me at home, great. If not, please try to find a facility that has an outdoor space where I can sit in the sun regularly. Please do not force me to eat – this includes any sort of feeding tube or caregiver trying to get me to take bites of food. With the exception of medication for pain (including opiates), please do not administer any medication – not even a flu shot or antibiotic – that may prolong my life. In fact, if my proxy/ caregiver is able to do so without incurring liability, please just administer water and/or wine until I pass peacefully; I would be most grateful.
With the aforementioned said, I also understand from my own experiences with my dearly beloved mother that the management of a patient until such time as he/she actually dies, can be extraordinarily intense. Namely it is one thing for a loved one to express that they want “no heroics” undertaken, but quite another to ensure that they don’t 1) suffer painful spasticity due to prolonged inactivity or stroke, 2) develop open pressure ulcers, 3) become a general burden due to the realities with which the family/ caregivers are dealing.
If my death is to be an unfortunately prolonged one, I respectfully request a caregiver (paid for one through my Genworth long-term healthcare insurance) be engaged to look after me. The caregiver should kindly respect the wishes I have articulated in this letter: Hospice. Sun. Let me drink wine and listen to classical music if my “hospice state” allows for it. Every effort should be made to avoid that I develop spasticity or pressure ulcers (they will add unnecessary stress to those charged with my healthcare needs). To the latter, frequent repositioning, vigorous massage, air mattresses and cushions, and topical ointments/dressings are suggested.
Perhaps in the future there will be more options available to end one’s life with dignity than are available today. Currently from a legal standpoint, were I to have a terminal illness, the only option to ending my own life with dignity would be to live in a state or country where assisted suicide is lawful. If I am eligible due to a terminal illness by which I have been given 6 months or less to live, I will opt to do this.
I’d like to preempt here and say that if someday the laws change and it may be possible to give consent prior to the advancement of Alzheimer’s, Dementia, or other brain injury/ disease, I hereby give said consent. My designated advocate is authorized to move forward on my behalf to implement whatever assisted suicide option might be available at the time.
Finally, should I have the misfortune of becoming impossibly cantankerous due to my advanced age or illness, please consider cannabis or other mood enhancing drugs to help make me more tolerable to those around me. And for God’s sake, have mercy and trim my chin and upper lip hairs.
I hope I have covered all the bases. I love you all family and friends. Onward!
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