Question
8: Do you want to be put into a nursing home? If
so, for how long, under what conditions, and
for what purposes?
If you lose the ability to take care of yourself, the
question of nursing-home placement will be raised. While
you are still in good health, you might think that
living in a nursing home would be a fate worse than death. But
before you declare you never want to live in a nursing home, you
should explore the question as deeply as you can.
You might be rejecting nursing homes because of misconceptions. How
much actual information and experience do
you have with nursing homes and other forms of assisted living? If
you have a solid basis for your views, this
is the place to explain the background of
your decisions about nursing-home placement. If
your rejection of such institutions is based in reality, then
your decisions are more likely to be respected.
Is there any middle ground between death and nursing home? One
rational thing you could do is visit various nursing homes that
could be possible places for you to live if the need arose. Also
you should consider the possibility of a temporary placement in
a nursing home, while you recover from a problem that
usually does have a predictable period of convalescence. A
nursing home can provide a needed break for
those who have been caring for you at home.
But because some of these 'temporary' relocations stretch
into placements that become permanent, it
might be wise for you to project some limits on nursing-home care. For
example, if you do not recover your health well
enough to return home within two years, and
if you have also affirmed your right to die at the best time, perhaps
it is now appropriate to begin your end-of-life planning. How
long would you approve living in a nursing home?
The nursing-home decision often takes place on the cusp between being
mentally able to conduct your own life and losing that capacity. Thus
the best thinking you can provide while
you are still clearly able to conduct your own life will
help those who must decide for you if you lose mental capacity. While
you still have all your mental faculties, you
probably do not want
to live in a nursing home.
106
YOUR LAST YEAR: CREATING YOUR ADVANCE DIRECTIVE FOR MEDICAL CARE