When Frank Sinatra crooned, “I did it my way,” we're sure he wasn't referring to how he handled his health care plans. But “My Way” does make a great soundtrack to the task of planning ahead for your own health-care needs. If you don't act on its message, you could be part of this sobering statistic: One in four older Americans say that they — or a family member — have endured excessive or unwanted medical treatments.
That's 25 million Americans who've undergone procedures, received medications and/or had medical tests they would have preferred not to have — a situation more likely to happen when you haven't made or can't make your wishes known.
It's a tough topic to discuss, and that probably explains why only one in four Americans has an advance directive, the two-part protection plan for living life your way (and that probably explains why so many folks get treatment they don't want). An advance directive includes a living will that lets family, friends and health care practitioners know what types of medical care you want and don't want in a health crisis. It also contains a health-care power of attorney that designates a relative or friend to carry out your wishes if you can't speak for yourself.
Advance directives aren't just for older people. Every adult needs one. In one 2010 study from Johns Hopkins Bloomberg School of Public Health, 60 percent of adults age 18 and older said that they want their wishes respected in a health crisis or at the end of life. Yet just 30 percent of them had an advance directive. If you're in that group, what are you waiting for? Maybe you just don't want to think about it, or you feel squeamish about discussing it with loved ones. Perhaps you assume your family or doctor will just know what you want. Or maybe you're not sure how to create a plan that will really protect you from unwanted medical care — and give you the care that matters to you when you need it most.
These steps can help (go ahead and hum “My Way” as you get started):
Think about it, then talk it over with your partner, loved ones or a close friend. Start talking about what you want and don't want in a life-threatening health crisis. You can think about options like artificial breathing, artificial feeding, having your heart re-started if it stops or other extraordinary or heroic measures. If you're thinking, “Hey, doc, I may want one thing at 35, but something else when I'm 105,” you're onto something. It's a good idea to revisit this conversation and update your living will from time to time, to reflect what's important to you.
Find help online. One good resource that can help steer you through this conversation is the Five Wishes workbook developed by the Robert Wood Johnson Foundation (www.agingwithdignity.org). You can order it or use the online version. It meets legal requirements for advance directives in 42 states and applies to all 50 when it comes to choosing a health-care proxy. You don't need a lawyer, but having one could help make sure you cross all your T's and dot all your I's. And you will need a witness to sign the papers.
Make it official. Advance directive rules vary a bit from state to state. Find out what your state requires at Caring Connections (www.caringinfo.org), a website sponsored by the National Hospice and Palliative Care Organization. Their site also offers advice about discussing your plans with your family (including what to do if loved ones disagree with you) and turning those plans into an advance directive.
Hand out copies to the right people. These include your doctor, the person you've appointed as your health-care proxy, family members, close friends and anyone else who may be caring for you. That's doing it your way!
Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Dr. Michael Roizen is chief medical officer at the Cleveland Clinic Wellness Institute. For more information go to www.sharecare.com.