Elders address Native health care concerns

Fairbanks, Alaska (AP) 11-07

When Colleen Anagick was putting together a health care decision-making workshop, she enlisted her mother, Eva Merrifield, to talk about and prepare a living will and durable power of attorney.

It was hard to talk about such complex issues with a loved one, she told an audience of elders at the Alaska Federation of Natives Elders and Youth Conference during October.

Anagick’s mother, who is healthy and active, wasn’t interested in conversation about terminal or end-of-life issues. “It was emotional,” said Anagick, a social worker at the Alaska Native Medical Center, but necessary for her mother to make her own health care wishes known in advance for her family’s sake.

“There are six kids in my family, and it would be a miracle if we all agreed on one thing at one time,” Anagick said.

Before Monday’s 90-minute workshop ended, the audience heard other personal stories that could have been less stressful if some health care decisions had been made beforehand.

Elders learned how to go about letting their family, friends and health care providers know how they would like to be cared for in the event of a serious illness or injury via a living will.

They also were given information on how to choose health care proxies to make decisions for them if they were unable to do so themselves via a durable power of attorney.

The two advance directives are easy to obtain on the Internet or at health services, and once they are filled out, signed and notarized, they become legal documents.

Advance directives can be changed at any time.

A 12-page printout with both advance directives is available on the state of Alaska Web site at www.state.ak.us and by searching for “advance health care directive.”

“Individuals are living much longer with chronic illnesses,” Anagick said, listing some such as diabetes, cancer, lung disease, kidney disease, liver disease, Alzheimer’s and complex childhood medical conditions.

Advances in medical science now allow people survive in many cases where they would have died in the past, she said.

This in turn puts the added burden of new health care decisions on family members as to whether individuals move to Anchorage, out of their own community and culture or go into a nursing or assisted-living home.

Unexpected situations such as accidents also can involve families having to decide whether or not their loved ones should or should not be put on breathing machines, feeding or hydration tubes, etc.

Advance directives are very useful in those situations as well. Without a living will or someone to speak for you, medical interventions to keep life going often can prolong suffering.

“When you don’t make advance directives, the full play of medical technology just rumbles along,” said Michelle Moran, who works with cancer patients at the Alaska Native Medical Center.

One audience member, Priscilla Sage, who had durable power of attorney for her uncle and his Living Will in place, stressed how important it is to make sure all hospital personnel, both doctors and nurses, are aware of the patient’s legal wishes and that health care directives be made visible in the patient’s room.

While Sage was gone from her uncle’s hospital room, he had a heart attack and CPR was used to revive him.

“He did not want to be revived,” she said. “It broke my heart.”

Another elder in the audience suggested that not only elders but everyone see to making their health care wishes known and legal, including young people, ages 17 and older.

Making those decisions in advance can avoid some very unpleasant consequences and a lot of pain, such as long drawn out legal and family disputes.

“If you can spare your family from having to make those decisions, that’s a great gift from you,” Moran said.

Information from: Fairbanks Daily News-Miner,