Advance Directive MD

04/16/2025

🎶 To tune of “My Favorite Things” for National Healthcare Decisions Day🎶

[verse 1]
Proxies on pages and signatures witnessed
Discussions with fam'lies in case there is sickness
Agreement if there are many offsprings
These are a few of my favorite things

[verse 2]
Copies in places where people can find them
Knowledge of wishes that prevents the mayhem
Prepared for any and all that health brings
These are a few of my favorite things

[chorus]
When the stroke hits, when the heart stings
When you're feeling bad,
An Advance Directive steps right into place
And then your care is iron-clad

02/24/2025

How exciting! I was appointed as a Director to the Board of Directors for the Maryland Academy of Family Physicans this past weekend!

Thank you to my mentors who got me here, especially Dr. Kathryn Hart, MD, FAAFP who encouraged me to apply to the board.

Additionally, thank you to Dr. Mozella Williams, MD MBA who once told me the way to keep more primary care doctors in Maryland is to train them in Maryland. She also kept me in the advocacy loop over the years.

What an honor!

I am specifically here to represent private practice physicians, physician entrepreneurs, and physicians in non clinical roles with my research role.

This group of driven physicians is ready to advocate for family physicians in Maryland!

01/26/2025

Success story! One of my patients is a woman in her 70s, a former race car driver, and a divorcee. Her adult children live many states away and both are busy with their own children.

For the past few years at her annual Medicare wellness visit, I’ve asked her if she has created an advance directive. Every year, she says no. I’ve encouraged her to at least think about who she’d want as her medical decision maker.

Like so many of my patients, she states she doesn’t want to be a burden.

Translation: she is worried about naming her children as her medical decision makers because it is a lot of responsibility and she feels guilty about this.

I hear this so often.

I remind patients that by *not* having these conversations about end-of-life preferences, one can actually become *more* of a burden. When families do not know what to do, they are torn, and often err on the side of more aggressive medical interventions. This leads to more anguish and guilt - “did I make the right decision for my mom?”

But, I said this is a success story, right?

Well, this year at her annual Medicare visit, I asked her whether she had made an advance directive. With a beaming, proud smile, she said “I did it!” I matched her smile! She said a weight was lifted off her shoulders.

In primary care, we don’t have a lot of time with patients. We do have time to plant seeds, though. And that’s what I did here - planted a seed the grew and grew. It grew so big it could no longer just be an idea. It was an idea that took root and called for action!

So here we are, moving the dial on creating advance directives. Just one person at a time, but for that one person and her family, this could make all the difference.

01/24/2025

Myth or fact: you need a physician or attorney to create an advance directive.

This may surprise you, but this is a myth!

In most states, you can complete an advance directive on your own!

But how?

Just download your state advance directive by googling “advance directive [your state]” and you can generally easily locate your state form. If you can’t find it, you can also use the “Five Wishes” document as a legal advance directive in most states. Easy peasy.

Taking that first step is the hardest part!

And don’t agonize over filling it out once you get it! Just do your best, and know that you can always update it! Just remember, most important part of the process is the conversation you have with your loved ones who will be left to care for you.

Here is Maryland’s advance directive. Easy to find, free, and no need for a physician or attorney. You don’t even need it notarized!

12/12/2024

When I was a first year resident seeing patients in the Intensive Care Unit, I was immediately struck by how many families were completely unprepared to make tough medical decisions for their loved ones.

Their anguish was almost palpable.

But then I noticed something.

Families who had previously had even a *single* conversation with their loved ones about end-of-life preferences seemed to be dramatically less stressed.

I thought, more people need to be having these conversations. It turns out, only 36% of people have an advance directive.

However, while having an advance directive as part of an estate planning package was helpful, I saw that the document often lacked the nuances we needed to make confident decisions in a medical setting.

I made it a mission to educate people on making informed, meaningful advance directives. I teach courses on the subject and I recently launched my online course “create an advance directive with a physician.”

And now, I have the distinct honor of being invited to join the Advisory Board for The Washington Home. This incredible charitable foundation provides funds to a wide variety of causes that support seniors in the Washington, D.C. region.

Together, we are working to spread the word about advance directives. Through their website, they offer my course to the people they serve.

The Board of Directors and Staff of The Washington Home are pleased to welcome the newest member of our Advisory Board, Eleanor Tanno, M.D. of Advance Directive MD. With her extensive expertise in the care and well-being of older adults, Dr. Tanno is an influential leader creating awareness and resources to help older adults prepare for their medical care later in life. We appreciate her time and perspective to support TWH grant initiatives for our community.

11/21/2024

I have a really exciting announcement.

This week, I was appointed by Montgomery County Executive Marc Elrich as a commissioner to the County Commission on Aging.

As a family physician who cares for hundreds of seniors, I hear their unique struggles daily. Among them, the struggles of aging in place, medication costs, rising housing costs, and loneliness. I hear about more and more physicians not accepting Medicare and the difficulties for seniors to find physicians.

These are complex issues, and the Commission is the dedicated team to tackle them.

I am proud to join this team and looking forward to a great two year term.

10/26/2024

Wondering what's needed to ensure your medical wishes are honored if you become sick or injured? It's National Estate Planning Awareness Week, and some key items to consider as you age include future financial management and healthcare decisions - what your concerns and wishes are for treatment and care.

The Washington Home has informational Advance Directive resources available that have been prepared by Eleanor Tanno, M.D. of Advance Directive MD to help you get started on your healthcare decision planning. View online at www.thewashingtonhome.org/adguide

Villages Iona Senior Services Hayes Senior Wellness Center We Are Family Senior Outreach Network Georgetown Village Capital Caring Health Cleveland & Woodley Park Village Dupont Circle Village East River Family Strengthening Collaborative, Inc. East Rock Creek Village Genevieve N. Johnson Senior Day Care Center HelpAge USA Home Care Partners Northwest Neighbors Village Capitol Hill Village Palisades Village DC Seabury Resources for Aging Unity Health Care DC Waterfront Village

10/24/2024

I had the distinct honor to be invited to speak about advanced directives by the Burning Tree Village. They had so many interested members that they partnered with the Fox Hill Independent living community to offer a venue with more space.

I was able to clarify many points around choosing a medical power of attorney, a strategy for documenting medical wishes, and clarify the role of the MOLST form.

If you have questions around these things and have been meaning to create an advance directive, make this the year! I offer the definitive online course on how to create an advance directive from start to finish.

Learn more about my online course here:
Www.AdvanceDirectiveMD.com

10/02/2024

Four pitfalls to avoid when choosing a medical decision maker (aka medical power of attorney)

1. You are estranged from your spouse. If you do not have an alternative decision-maker legally named, your estranged spouse will still be able to make life-changing decisions for you in most states.

If this idea makes you squeamish, you should legally name an alternative medical power of attorney through your advance directive.

More videos to come. Stay tuned!

08/28/2024

Do not fear the persistent vegetative state.
You should plan for more common fears.

I wrote this article after reading a recent The New York Times article by Carl Zimmer

You should have bigger fears. By Eleanor Tanno, M.D. “Doc, I’d never want to live like that” or “I never want to be a vegetable!” These are common refrains I hear from patients when discussing their medical end of life wishes. But a recent New York Times article by Carl Zimmer explains how...

08/16/2024

AI to make your end-of-life decisions?

A new AI tool is being designed to do just that.

It will scour your emails, internet searches, and social media activity to predict the kind of medical care you would choose if you were too sick to make your own decisions.

I think most people who read about something like this will feel this goes too far. Technology making one of the most personal decisions of your life—that between living and dying? How do I opt out?

But.

Only 36% of people create an advance directive at all. Which means most people leave zero guidance for their loved ones.

Suddenly this AI tool seems like the lesser of two evils, no?

Also, even though something like this could model your preferences, a surrogate would still need to implement it in the hospital. Doctors cannot just click a mouse, see an AI generated recommendation and follow it blindly. They would still depend on a patient’s medical decision maker to provide the final recommendation.

To summarize, an AI tool to predict end-of-life preferences may seem impersonal, but the most common alternative of no directive is even more impersonal.

Take some time, think about your values, and talk to your loved ones. Use my free step-by-step guide to creating an advance directive if you’d like to get started today.

MIT Technology Review

The use of technology to bolster patient autonomy might suit American sensibilities more than others.