MANILA, Philippines - Over the last year or so, two of my dearest friends have had a parent ill with some form of cancer. I have been blessed for being allowed to watch my friends care for their ill loved-ones. I have seen how their parents’ illnesses have transformed them into better, more compassionate human beings. I marvel at the tenacity and strength of spirit of both cancer patients and their kin who take care of them, their sense of humor in the wake of life-threatening moments and situations.

All of us will one day have to go. Some families are given the blessing of having time to prepare loved ones, others are not quite as blessed. In my own family, I’ve had the experience of losing someone so suddenly to a massive heart attack, with no warning at all. In another instance, we had more or less two weeks to “prepare” for his passing.

Admirable

In the hospital where I work, I have seen many families struggle with decisions that come towards the end of life of some of their loved ones. The question—“What would he/she have wanted us to do?” is a question that is asked my many families who have terminally ill members who have reached the point where they are unable to decide. I suppose at some point in time, whether you are 40, 50 or 60 and above, it is always best to be ready and prepared.

One of the most admirable people I interviewed when I was a reporter was Marisette Galang. She passed away in 2005 from breast cancer. I first met her in 2002, when she had been diagnosed with breast cancer in 1997. At the time of our interview, she had already set out all the plans that her family was to follow during her last days on earth. I was so impressed with her list! It was as thorough as it could get—down to the dress that she would wear at her wake.

I remember her telling that she did not want to burden her family with having to make all these decisions on her last days or after she was gone. I would use Marisette’s advance directives in my grief classes at the Ateneo. It never failed to awe, and at the same time, inspire my young students.

Several types

An Advance Directive tells your doctor what kind of care you would like to receive if you become unable to make medical decisions. A good advance directive describes the kind of treatment you would want to receive depending how sick you are. There are several types of Advance Directives—a living will, a special power of attorney, or a do not resuscitate order.

Any hospital worth its salt will honor and respect a patient’s Advance Directive. A living will is a written, legal document that describes the type of medical treatments you are agreeable to when you are terminally ill. A special power of attorney or a health proxy is an authorization in which the patient designates another person (in most families, this either the spouse, the eldest child or a family member with a medical background) to make medical decisions for them.

A Do Not Resuscitate Order (DNR) is a request against CPR in the event that your heart stops, or if you stop breathing. A DNR is written in the medical chart by the attending physician.

‘Living will’

In the United States, there is a document called the Five Wishes created by the non-profit organization, Aging With Dignity.

It has been described as “the living will with heart and soul.” The Five Wishes is a nationally recognized document that was set into place by the American Bar Association’s Commission on Law and Aging and top medical experts in 1998. More than 11 million documents such as these have been used in the United States.

It would be interesting to see this kind of document institutionalized and legally recognized here in our country.

We are a people who generally do not like to talk about death, so having a document such as this would definitely spare many families from the agony of having to wonder about what the loved one would have wanted in his or her last days here on earth.

Briefly, the Five Wishes covers the areas of medical care, treatment, spirituality, forgiveness and other last wishes. It is in essence a combination of both a living will and a special power of attorney (SPA).

Five Wishes

The Five Wishes are broken down as follows:

Wish 1: The Person I Want to Make Care Decisions for Me When I Can’t

Similar to an SPA, a person is assigned to make medical decisions on the patient’s behalf when that time comes that he/she is unable to do so.

Wish 2: The Kind of Medical Treatment I Want or Don’t Want

Similar to a living will, it defines what kind of medical treatment you will accept; and whether you will want life support treatment or not.

Wish 3: How Comfortable I want To Be

Here, the patient talks about the type of pain management procedures he/she will want and when the treatment is to be administered.

Wish 4: How I Want People To Treat Me

This “wish” describes whether you want to spend your last days at home. It discusses personal matters—whether you want to accept visitors or you wish to keep to family members in your last days.

Wish 5: What I Want My Loved Ones To Know

This section deals with matters of forgiveness and talks about funeral plans.

The Five Wishes document is then signed by the patient, in the presence of witnesses and affirmed by a lawyer.

Although we do not yet have this type of document here, it makes very good sense to be prepared for the eventuality of one’s passing on.

Announcement: Griefshare, a support group/workshop for anyone who has lost a loved one, will open on Oct. 17, at the Greenhills Christian Fellowship church in the Ortigas Center. Please call 0917-529-1964 or email griefisajourney@gmail.com to reserve a slot.

E-mail the author at cathybabao@gmail.com