Top Doctors: Planning for end of life
Some people will reach their final days without the ability to communicate. That's where advance health care directives come in: They allow people to maintain control over decisions when they can't speak for themselves.
Here's what you should know:
1. YOU'RE IN CHARGE OF DECIDING WHO SPEAKS FOR YOU
Everyone should consider choosing a person to be what's known as a health care proxy, but this is especially important if you're older, said Dr. Lucy Macina, an attending physician in geriatric medicine at Winthrop University Hospital in Mineola. This person -- perhaps a family member or friend -- would have the power to make medical decisions if you're unable to do so.
You should talk to the person about your beliefs regarding the type of medical treatment you'd be willing to undergo. "If you reach a point where you're suffering or your quality of life is very poor," Macina said, "how do you want that to be handled? Are you someone who wants to be kept comfortable? Or are you someone who wants everything done?"
2. A HEALTH CARE PROXY FORM MAKES YOUR CHOICE OFFICIAL
The document, which should be available at your doctor's office or a hospital, designates the person who will speak for you.
Dr. Geraldine Lanman, an internist and geriatrician in New Hyde Park, suggests that you give one copy of the form to your doctor, keep one with your will and carry a laminated copy (in miniaturized print) in your wallet. "If disaster strikes, I can explain the situation and the various options to the agent, and then ask the agent what the patient would say if they could speak," Lanman said.
Or, you could designate your doctor to make decisions for you. "Many patients will say, 'I want you to do what you think is best,' and we make the decisions," Macina said. "You could make the doctor your proxy, or you could just let your doctor know what your wishes are, and the doctor would follow those wishes."
3. DON'T WORRY ABOUT CONSIDERING ALL POSSIBLE SCENARIOS
It's not necessary to talk to your designated proxy about everything that could happen on the medical front, Lanman advised. "As long as you trust that person to try their best to think like you, there is no need to try to ferret out all potential medical ends," she said. "Just trust that your doctor and your agent will do the very best they can to provide you with the care you would wish for yourself."
4. A LIVING WILL IS ANOTHER OPTION
A living will allows you to declare your wishes about medical treatment, particularly issues like cardiac resuscitation, tube feeding and artificial respiration, or use of a ventilator. You would make the call ahead of time, rather than leaving it to a proxy. The New York State Bar Association (nysba.org) offers living will and health care proxy forms designed for New York residents.
5. TALK TO YOUR PARENTS ABOUT THEIR WISHES BEFORE THERE'S A CRISIS
Macina suggests you adopt an upfront approach and try something like this: "There may be a time when I will have to make a decision based on your wishes. If you get very ill and there is a good chance that you're going to die, how do you want me to approach that? I want to do what you want me to do. I want to carry out your wishes."
The conversation may not be as tough as you might imagine. "Honestly," she said, "many older patients have thought about this already. They've made up their minds and have an idea what they'd want."
Geriatric medicine
This is the 15th installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.
Dr. Irving Gomolin
222 Station Plaza N.
516-663-2588
Dr. Geraldine Lanman
1 Delaware Dr.
516-326-5320
Dr. Lucy Macina
222 Station Plaza N.
516-663-2588
Dr. Gisele Wolf-Klein
2800 Marcus Ave.
516-708-2520
FAMILY MEDICINE
Dr. Alex Aponte
Westhampton Primary Care
80 Old Riverhead Rd.
631-288-7746
Dr. Robert Arcati
530 Hicksville Rd.
516-931-4285
Dr. Anthony Arcati
530 Hicksville Rd.
516-937-5000
Dr. Stanley Blyskal
126 E. Main St.
631-581-0090
Dr. Luigi Capobianco
One School St.
516-671-9800
Dr. Martin Edelstein
11 Beverly Rd.
516-487-1614
Dr. Michael Fishkin
2500 Nesconset Hwy.
Bldg. 7D
Stony Brook
631-751-3322
Dr. James Giugliano
290 N. Sea Rd.
631-283-5900
Dr. Louis Greenblatt
533 Rte. 111
631-366-1788
Dr. Kenneth Levites
213 Montauk Hwy.
631-563-6205
Dr. Brian Moynihan
2840 Jerusalem Ave.
516-781-1141
Dr. Lesley Rechter
54 Birchwood Park Dr.
516-933-6850
Dr. Hans Dieter Schwinn
80 Old Riverhead Rd.
631-288-7746
Dr. Neil Soskel
185 Merrick Rd.
516-887-0077
How they were picked
Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.
Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.
Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.
To see the whole list . . .
Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.
Updated 17 minutes ago Human remains search expands ... Trump hush money trial ... Year-round tick problem ... FeedMe: Pizzeria Undici
Updated 17 minutes ago Human remains search expands ... Trump hush money trial ... Year-round tick problem ... FeedMe: Pizzeria Undici
