High on the shelf amongst my cookbooks and family photos is a special folder. I put this together several years ago before I was scheduled for a procedure on my heart. It is colorful with pink and red roses and adorned with a metal butterfly and spider. The message on the card reads... "May the spirit of nature bring you peace and joy". The flip side of the quote advises my family to open this if I am unable to make my own health care decisions, or if I should be diagnosed with a terminal condition which I will not survive and it is here where they will find my advance directive, power of attorney for health care and any other pertinent information they would need pertaining to my earthly remains.

You see, as a nurse, I talk with patients and families very frequently about living wills (advance directives) should they become incapacitated and unable to make their own health care decisions. We should all have a living will and power of attorney for health care in place. But... life gets busy, we do not wish to think about such things and it does not get done.

It costs no money and does not require a lawyer. It does require the signature of two witnesses who would not in anyway benefit from your demise. The advance directive is usually a pre-printed form that you may obtain from your hospital or doctor that tells your medical wishes if you are unable to make them known and the power of attorney for health care listing who you would want to make those decisions if you are unable to do so. In the advance directive you can specify your wishes should you be diagnosed in terminal condition and not expected to survive. This may include no CPR, no ventilator, no nutritional support, etc. You are in charge of these decisions while you are able and you can make your wishes known. This does not go into effect until you are deemed in terminal condition. Up until that point, everything would be done to attempt to reverse a life threatening situation.

It is important to discuss your wishes with your family and to let them know where these important papers are located. Each time you are admitted to the hospital, you will be asked if you have such documents and will be requested to bring a copy to be placed on your chart. At any time you may change your mind, tear them up and start anew.

I have seen families torn apart when they must make a decision for a loved one who is on life support and in spite of heroic efforts will be unable to survive and have quality of life due to a deteriorating condition. No one wants to lose a loved one. It is so difficult making these decisions. But with an advance directive giving the family explicit instructions that this would not be a life you would want to live, it makes their decision just a little bit easier and helps everyone to come together in making a decision.

Technology has definitely complicated the process of living and dying. We are all mortal beings and someday will come face to face with our own mortality. Yes, we can be kept alive with machines as our bodies and minds continue to deteriorate. This is not living. This is not quality of life. This is quite simply... prolonging the dying process. To what avail?

Make a decision now to be in command of your life choices. Complete an advance directive and power of attorney for health care. Discuss this with your family and those entrusted with decision-making capabilities. And let them know where they may find these documents, and then get on with the joy of living!