[Ruth]
 
I'm 75 years old. I was recently diagnosed with early-stage breast cancer. I haven't had too many health problems, other than heart problems and a mild stroke two years ago. Turns out my chances with my breast cancer are very good, but I'm still worried about having another stroke. George and I have been married for 52 years now and he depends on me for so much. If I have another stroke, a bad one, he'd have to make some hard choices if I couldn't decide for myself. I've already told him that I wouldn't want to be kept alive by machines. But, I know it would be hard for him to tell the doctors to take me off life support. So, I decided to put my wishes down in writing, so he won't ever have to make that choice.

[Ruth]

I called the social work department at my local hospital and asked the social worker for some information about a living will. She suggested I use a document called "Five Wishes" from an organization called Aging with Dignity. She gave me their phone number and Internet address. When I called them, they were very helpful and sent me a copy of the "Five Wishes" form. I felt a sense of relief when I received that form -- it gave me a way to take care of something very important to George and me. I took out a sheet of paper and started listing what's important for maintaining my quality of life. Then I asked myself some hard questions. First of all, who would I want to make health care decisions for me if I couldn't make them for myself? I wrote down my husband, but then I thought about my oldest daughter, Annie, and a couple of my closest friends. So, I wrote down their names, too, and reasons why I should or should not choose each person. It's too important a decision to make all at once, so I put this sheet of paper away and re-read it a few days later. I added some new reasons that I thought about to the list and crossed off other ones. After this, I felt pretty comfortable with my decisions.

[Ruth]

The next question from the "Five Wishes" is what kind of medical treatment I would want if I became seriously ill or were dying. Do I want life support treatments, like being put on a respirator, or would I want to be resuscitated -- have my heart started again if it stops? Do I want blood transfusions, or kidney dialysis, or to be given food by tubes? What about antibiotics if I get pneumonia? There's a complete list of questions in this "Five Wishes" document -- many you could never think of on your own. My social worker told me that the "Five Wishes" document is a legal document in the state where I live. So, my answers are very important and I know my wishes will be carried out. 

[Ruth]

First, I needed to talk with George and our daughter, Annie, about my decisions. At first they were uncomfortable -- these things are not easy for people to talk about. They kept telling me that my cancer was caught early and I shouldn't be worrying about what might not happen. But I knew we would all feel better once we talked about it and knew we had a plan together. So, I told them what I had to say was very important and that they should listen to what I had decided and why I had arrived at my decisions. I told my husband that I would like Annie to be my health care agent. After all, she has had some training in health care and is comfortable in hospitals and talking with doctors. I also told George that I honestly think it would be too hard for him to make these kinds of decisions. I knew his feelings might be hurt… maybe they were. Well, we were all nervous about talking about these questions. But, I'm certain we all felt better knowing what to do -- not knowing would be much worse.

[Ruth]

Annie had some questions about my answers on the form. So, we finished it up and agreed that George and I would go discuss the document with our lawyer and then give a copy of it to all of my doctors and the hospital where I get treated, so that it can become a permanent part of my medical record. I have to say that this whole experience has really helped all of us feel so much closer. And, now we can look to the future feeling a lot more secure.

[Narrator]

You can obtain a copy of the "Five Wishes" document by calling 1-888-5-WISHES (1-888-594-7437), or on the Internet at www.agingwithdignity.org. "Aging with dignity" is one word in the Internet address. Keep in mind, too, that "Five Wishes" is only one example of a document for making sure that your wishes at the end of life are followed. Each state has a form of its own and your lawyer, doctor, or hospital can assist you with finding copies.

[Narrator]

Once you have made your mind up on important questions about your medical care, you may need to get prepared to solve other challenges or problems that may come up.
 
[Social Worker]

We know that we often find solutions to a bigger problem when we break the bigger problem into smaller pieces, and then work on the smaller problems first. When working with cancer survivors, I find it also helps to think about other major problems we've had in our lives and to think about how we solved them -- what we did right, and what we could have done better. Previous problem solving can offer a blueprint for how to deal with current problems.

[Narrator]

Doris is a good example of this. She lives in a small town and feels very lucky that all of her children have stayed nearby, instead of moving away like the children of so many of her friends. Listen to how Doris and her children dealt with a major family problem.

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