Every week families are faced with the stark reality that we no longer die in quick or convenient ways. Every week families are faced with an ever-widening array of initials, acronyms, and code words that represent the hundreds of programs and determinations that get made by our medical establishment at the end of life. Familiar terms like Medicare take on new meaning and new dimensions and it becomes apparent that choices made during senior years are not necessarily good choices at life’s end.
This swirl of facts, figures, programs and recommendations is then made even more complex by the addition of expectation, obligation, and family prejudices. If I had an extra nickel for every time that I heard a tearful daughter or sullen husband tell me that the patient we were discussing made them promise never to put them in a nursing home I would not need to write these articles to drum up business. I don’t have those extra nickels. But there is a generally pervasive attitude that Long Term Care is inherently not the first choice. And, of course, we all want to best for our loved ones.
In the middle of this swirl, we often find that the thing that is most overlooked, the thing that is most easily disregarded, is the actual desire of the patient. This desire is rarely expressed clearly and cogently to family. It is often not expressed at all in the present and must be discerned from documents executed during a more lucid time. A neutral, professional, third party can discuss things that loved ones just cannot bear to utter. Elder law attorneys focus their practice on understanding and meeting the needs of those in end stages and their families. Discerning the desires of the patient is a key component in that process.