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CWW House 1

To enhance the ability of its members to age well, and to age "in place."

Five particular documents were offered, each of which deserves our attention. More importantly, each of these should serve as a focus of discussion between the members and their families.

1.  Putting My House in Order

2.  Advance Directive or Living Will
3.  Health Care Proxy or Health Care Power of Attorney

a.  Discussion of synonyms and confusion of names
b.  Combined directive which includes #2 and #3 above

4.  Expression of personal wishes

5.  Emergency Card (keeping everyone aware)

WHAT IS EACH OF THESE RESOURCES?

1.  PUTTING MY HOUSE IN ORDER

This is a workbook of the Funeral Consumers Alliance of Princeton used to help organize information about our possessions, bank accounts, investment accounts, insurance policies, wills, passwords, and so on. All of it information that will be essential for our families, executors and attorneys when we die.

2.  LIVING WILL or INSTRUCTION DIRECTIVE

Often loosely referred to as a Living Will, this is a document in which to explicitly state if you feel there are medical conditions which would lead you to decide to forego all medical treatment, including life-sustaining measures, and accept an earlier death.

3.  PROXY DIRECTIVE or DESIGNATION OF HEALTH CARE AGENT

This is a form in which you designate a person (a proxy) you trust and give that person the legal authority to make decisions for IF YOU BECOME UNABLE to make decisions for yourself.

4.  EXPRESSION OF PERSONAL WISHES

This form distributed by the Funeral Consumers Alliance of Princeton offers one means of recording your preferences for burial or cremation, type of funeral or memorial, information for death certificate and obituary, choice or location of funeral director or cemetary, if any, and so on. This is information that will often be unexpectedly called for, when we are no longer available to offer it.

5.  EMERGENCY CARD

A handy refrigerator magnet envelope and card, provided by the University Medical Center at Princeton, and discovered by Betty Fleming, should contain urgently needed medical information. This is a location in which police, rescue squads and emergency medical technicians are trained to look for it!

DISCUSSION OF EACH OF THESE ARTICLES

ALL OF THESE ITEMS ARE GIFTS FOR OUR FAMILIES. THEY ARE NOT FOR OURSELVES. BY THE TIME THEY ARE USED WE WILL NOT KNOW OR BE MUCH AWARE.

ALL OF THESE PAPERS WILL REDUCE THE BURDEN AND STRESS ON OUR FAMILIES. SOME WILL PREVENT QUARRELS AND DISPUTES, AT A TIME WHEN WE WOULD PREFER OUR FAMILIES COME TOGETHER IN MUTUAL SUPPORT.

1.  PUTTING MY HOUSE IN ORDER

The title "Putting My House In Order" is used for a wide variety of publications, all dealing with end-of-life. (They are put out by many funeral and memorial societies, a number of legal and medical societies, and philanthropic societies. Some include advance directives, many express what one wants for funeral and burial arrangements. most relate to financial matters. Ours derives from the old federation of memorial societies that formed in 1963. What the PMA used then was a simple two-page form listing some of the personal assets many of us have and where each of those could be found.)

It is the most work. It is self-explanatory. It is best not to try to complete it in one sitting. It may be easiest to come back to it and to a piece at a time.

It is a workbook with space to fill in much of the data needed by the people we leave behind and those who will settle our estates when we die or become unable to communicate it all. It includes location of documents and accounts, names of people who will have to be reached, like lawyers, and insurance agents. It is not fully comprehensive but covers a great deal.

To make it easier and keep it current, some of us keep the data in our computers. If you do, be sure there is at least one person who has the passwords and the technical knowledge to access the information!

A copy this form is on this CWW House 1 Web site in the "Members" section. COPY OF PUTTING MY HOUSE IN ORDER form. This version permits you to type directly into the PDF form. It is printable, along with the data you enter. Unfortunately you cannot store the typed-in information on the computer so it is less than ideal. (We are working on a Word format that you could save and easily update. . . . AND save printed copies.)

(I for one find this a very comforting form to use. It helps remind me of the things I have done for my wife and the family, as well as making it easy for me to update the information).

2.  LIVING WILL or INSTRUCTION DIRECTIVE
3.  PROXY DIRECTIVE or DESIGNATION OF HEALTH CARE
     AGENT

COPY OF THE COMBINED DIRECTIVE OFFERED AT THE MEDICAL CENTER AT PRINCETON

There are three kinds of advance directives:

1. Proxy directives -- One way to have a say in your future medical care is to designate a person (a proxy) you trust and give that person the legal authority to decide for you if you are unable to make decisions for yourself. Your chosen proxy (known as a health care representative) serves as your substitute, “standing in” for you in discussions with your physician and others responsible for your care. So, by a proxy directive we mean written directions that name a “proxy” to act for you. Another term some people use for a proxy directive is a “durable power of attorney for health care”.

2. Instruction directives -- Another way to have a say in your future medical care is to provide those responsible for your care with a statement of your medical treatment preferences. By “instruction directive” we mean written directions that spell out in advance what medical treatments you wish to accept or refuse and the circumstances in which you want your wishes implemented. These instructions then serve as a guide to those responsible for your care. Another term some people use for an instruction directive is a “living will”.

3. Combined directives -- A third way combines features of both the proxy and the instruction directive. You may prefer to give both written instructions, and to designate a health care representative or proxy to see that your instructions are carried out. So, by a “combined directive” we mean a single document in which you select a health care representative and provide him or her with a statement of your medical treatment preferences.

There was considerable discussion of these forms at the meeting. Henry expressed his personal preference, shared by many physicians that the most important elements are

1. naming of a health care proxy (and one or more backups in the event he or she cannot serve,

2. discussion of your values, feelings and preferences with your proxy and members of your family.

Narrow specific preferences in your instruction directives may be undesirable. We cannot know exactly what the circumstances will be when we die . . . or the specifically available medical equipment or technology that may be available.

(As Niels Bohr observed: "Prediction is very difficult, especially about the future."

A satisfactory form is available free at the University Medical Center at Princeton. It is a very basic combined directive.

4.  EXPRESSION OF PERSONAL WISHES

This form is distributed by the Funeral Consumers Alliance of Princeton, formerly the Princeton Memorial Association. It offers one means of recording your preferences for what happens after you die. Do you want burial or cremation? Do you wish to specify the type of funeral or memorial you prefer? Have you chosen a funeral director? or purchased a cemetery plot or do you have place in a family plot? Some people like to select certain music or readings for their service. It can be very helpful if you can provide information for the death certificate and obituary. A copy of the Funeral Consumers Alliance form is available in the members section of this Web site: Expression of Wishes Form

5.  EMERGENCY CARD

EMTs, police and rescue squads are accustomed to looking on the front of refrigerators for essential, emergency information. The University Medical Center at Princeton makes available as community outreach a very useful magnetic, plastic envelope to attach to the front of the refrigerator. The enclosed card has space to record the information that is typically needed in the event of a medical emergency

A copy of this form is available in the members area at page 1 and page 2:, but the physical card and envelope from the Medical Center is more useful. Get instructions for obtaining the card by clicking the underlined word.

Betty and Bob Fleming have made a template available in MSWord format so that we may record this information, save it in form to update conveniently, and reproduce in a size suitable for wallet or purse.

Worth reading:

From the New York Times
Care in Old Age: Confronting the Inevitable

If the NY Times is not available to you online, go to our members' tips section at newspapers online