After Death Decisions to Think About Now

After Death Decisions to Think About Now

Name & Date_______________________________________
After the death of a loved one, family and friends are often left with some tough decisions. You can help ease the pain and anxiety by making your wishes—about burial, autopsy, and organ donations—clear in advance.

Tool #5

ORGAN AND TISSUE DONATION

DID YOU KNOW? !  More than 68,000 patients are on the national organ transplant waiting list. Each day, 13 of them will die because the organs they need have not been donated. Every 16 minutes, a new name will be added to that waiting list. !  Organs you can donate: Heart, Kidneys, Pancreas, Lungs, Liver, Intestines. !  Tissue you can donate: Cornea, Skin, Bone Marrow, Heart Valves, Connective Tissue. !  To be transplanted, organs must receive blood until they are removed from the body of the donor. Therefore, it may be necessary to place the donor on a breathing machine temporarily or provide other organ-sustaining treatment. !  If you are older or seriously ill, you may or may not have organs or tissue suitable for transplant. Doctors evaluate the options at or near the time of death. !  The body of an organ donor can still be shown and buried after death.

1. Do you want to donate viable ORGANS for transplant? (Circle one)
Yes
Not sure
No If Yes, check one:
____ I will donate any organs.
____ Just the following: _______________________________
2. Do you want to donate viable TISSUES for transplant? (Circle one)
Yes
Not sure
No If Yes, check one:
____ I will donate any organs.
____ Just the following: ____________________________
Attention! If you circled Yes for either of the above, be sure to write this into your health care Advance Directive. You may also fill out an organ donor card or register as an organ donor when you renew your driver’s license. But be sure to tell your proxy and loved ones. Make sure they will support your wishes. Even with an organ donor card, hospitals will usually ask your proxy or family to sign a consent form.

ABA Commission on Law and Aging Tool 5 / Page 1

3. If you do not donate organs or tissue, you may choose to donate your WHOLE BODY for medical research or education. Would you like to do this?
Yes Not sure No
If you circle Yes, you must contact a medical institution to which you are interested in making this donation. Medical schools, research facilities, and other agencies need to study bodies to gain greater understanding of disease mechanisms in humans. But, this kind of donation must be accepted by the medical institution. Note that total body donation is not an option if you also choose to be an organ or tissue donor.
4. Would you agree to an autopsy? (Autopsies, done after death, are used for diagnostic and research purposes. The body can still be shown and buried.)
Yes Not sure No
BURIAL ARRANGEMENTS
5. I would prefer to be: (circle one)
Buried Cremated No Preference

6. I would like my remains to be placed:
   
7. What are your thoughts about your memorial service—such as songs or readings you want, or the people you hope will participate?
   
8. Other preferences:
   

ABA Commission on Law and Aging Tool 5 / Page 2
source http://www.americanbar.org/content/dam/aba/migrated/aging/toolkit/tool5.authcheckdam.pdf