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Cascade Observations: Party on, to the end

I’m no party animal, unless the festive menagerie includes slugs, sloths or oysters.

As a young kid, I was more likely to sit on the sidelines than join in to birthday party games. In college, I was more apt to be in the library at 11:30 p.m. than in a fraternity house quaffing a beer. Now, at 57 years of age, I’m frequently in bed, asleep, by 9:30 p.m.

That said, I do like to entertain, especially in the summer, when our deck is available for dining and the garden is exploding with delicious fruits and vegetables. This year I’ve probably cooked 20 pounds of tender green beans for family and friends, and my husband’s Weber barbecue is looking the worse for wear.

Martha Stewart would approve of my cooking, but not my decorating. If we have more than four people to dinner, the cloth napkins are a mismatched assortment of patterns and colors, softened by years of use. The plates are different sizes and shapes. Someone may have to sit on a stool when the number of chairs comes up short.

That’s why I’ll be hosting my next party at my mother-in-law’s much more spacious home. The guest list gets longer each day as I plan this newest event. No, it’s not a wedding shower or a 50th birthday party. Instead, friends and family will gather for an A.D.P. – an Advance Directive Party.

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For those readers who don’t know what an advance directive is, here’s the short definition: It’s a document that spells out your medical wishes if you are incapable of communicating them. In the crass vernacular, do you want to allow someone to “pull the plug?”

I started filling out my own advance directive this summer, helped along by a publication produced by Oregon Health Decisions. The booklet describes scenarios, and asks you to put yourself in those scenarios. Do you want life-sustaining treatment if you are unconscious and seriously ill? Do you want help breathing but not eating? Do you want to be artificially hydrated through a tube?

I thought the process of completing my own advance directive would be easy, but the more I read the more I wanted to talk with friends and family. I asked around, and it seemed many others were in the same circumstance. They had been given all the paperwork by a heath caregiver, and in some cases had begun to fill it out. No one, it seemed, had actually completed the task and handed it over to his or her physician.

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My friends were traveling to Seattle several weeks ago when they stopped at a rest stop to use the bathroom. Upon exiting, they noticed a woman who was having trouble walking. They were helping her to return to her husband and his truck when she collapsed. Some volunteers jumped in to begin CPR while my friends called 9-1-1. As her husband stood near, in shock, the paramedics worked on the unconscious woman. What seemed like hours later, she was declared dead.

For my friend, watching the agonizing process of trying to keep the woman alive confirmed his decision to DNR – Do Not Resuscitate. But it also brought up the problematic issue: If you don’t know about his or her advance directive, how do you know if a stranger does or doesn’t want this?

This is the situation my family found us in several years ago. My mother was clear that she didn’t want to be resuscitated, yet a sweet CNA at her assisted living facility proceeded to do so when she found my mom unconscious in her room one night. Her efforts “saved” my mother’s life, but didn’t honor her wishes.

After witnessing the woman’s death, my friend has come up with a brilliant, though slightly macabre, solution. With the proliferation of tattoo artists, why not permanently make your wishes known right on your skin? Something to think about, although it’s unlikely I’ll be getting inked any time soon.

Though I won’t be experiencing a tattoo needle in the near future, I will soon be needled when I go for my annual flu shot. Like the advance directive party, my husband and I try to make a potentially distasteful event — getting our flu shots — somewhat entertaining. We call it a “date,” and follow up the slightly painful poke with a nice lunch and a glass of wine. Who says I don’t know how to have fun? Party on!

If you think you might want to host an AD party of your own, make sure to have plenty of resources, including the booklet mentioned above. It is quite thorough, covering everything from breathing machines to living with dementia. The discussion questions are thought-provoking. You can get all the necessary materials from your physician or the local hospital, or by calling 1-800-422-4805.

Plan to invite family and friends. Witnesses are required when signing the forms. The witnesses must declare that the person filling out the advance directive:

n Is personally known to the witness and/or has provided proof of identity

n Signed or acknowledged that person’s signature on this advance directive in the witness’s presence

n Appears to be of sound mind and not under duress, fraud or undue influence

n Has not appointed the witness as a health care representative or alternative representative

n Is not a patient for whom the witness is an attending physician

Further, the form states “One witness must not be a relative (by blood, marriage or adoption) of the person signing this advance directive. The witness must also not be entitled to any portion of the person’s estate upon death. The witness must also not own, operate or be employed at a health care facility where the person is a patient or resident.”

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