"If in the judgement of my physician, I am suffering with a terminal condition from which I am expected to die within six months, even with available life-sustaining treatment provided in accordance with prevailing standards of medical care:
__I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible;
OR
__I request that I be kept alive in this terminal condition using available life-sustaining treatment (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)"
For me, it's pretty easy here. I initialed the first option. If I knew I was terminal, I would only want comfort care. The next question gets into more gray areas for me though.
"If, in the judgment of my physician, I am suffering with an irreversible condition so that I cannot care for myself or make decisions for myself and am expected to die without life-sustaining treatment provided in accordance with prevailing standards of care:
__I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible;
OR
__I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)"
I want to initial the first line, but I also really want to know what the condition would be. Doesn't everyone? I'm lucky; I have a great medical advocate as my medical power of attorney. I'm wondering how other people have worked through these topics though.
3 comments:
I hate the thought of filling out a living will. I just don't understand them. I told my son to pull the plug if the doc. says I will never wake up . I really should write it down so he won't have to make that choice. I have to decide for my mom and I hate it.
I know I'm a little late on the pick-up here, but this is an issue that was of great concern to me. Despite my mother's living will, each time she changed status within the medical system and/or entered a hospital or care facility, a new DNR was required. Because my mother was capable of understanding the implications of DNR's I always consulted with her as they were being filled out and we filled them out differently depending on where she was within the system and in regard to her health. For instance: When she was in the SNF the last time, having been diagnosed with lung cancer, we specified, in that DNR, that if she developed a condition that appeared to be imminently life threatening, because the SNF had no equipment and usually no staff that could expertly qualify this condition, she was to be administered life sustaining assistance(despite the possibility of broken ribs and sternum if this included CPR) and transferred to the hospital for further evaluation.
I discovered that SNF and Hospice DNRs (at least here in Arizona) are much more detailed than hospital DNRs. For instance, at both SNFs we were asked specifically about the possibility of dialysis or transfusions. Since she had chronic iron deficiency anemia and mild chronic kidney disease, deciding which of these to accept or abjure was important and, both times, we elected to have even more specific instructions included to define when either of these measures should be considered or denied. The amendments were always allowed. I think this speaks to your concern about "wanting to know what that condition would be".
I was alerted to the above possibility of elaborating on the language of DNRs, in fact, by the nursing supervisor in the first SNF in which my mother received treatment. The supervisor related a personal experience that involved a car accident she had experienced some years earlier. As a result of the accident she went into renal failure. She was also unconscious at the time and was classified as being comatose. She did not have a DNR. She told us that if she had had a "standard" DNR, she would not have received dialysis, which kept her alive and allowed her to heal to the point where her kidneys kicked back in.
As well, I discovered a couple of different times that a medical advocate (in my mother's case, that was me) can override what's already been written.
Funny, of all the struggling that was necessary as my mother's medical advocate, the least amount involved living will and DNR issues. It seems that the medical system in America, regardless of what a patient has chosen, is more likely, at this time, to err on the side of caution. Sometimes, of course, this is a problem. In my mother's and my case, it was to our advantage.
Karen, another reason to fill one out is in case they can't reach your son, or in case doctors question his authority to decide. Without clear direction, medical professionals will err on the side of doing everything. And just filling out the part that says not to keep you on life-sustaining treatment is not that overwhelming. I know other sections get a little graphic. But that first basic question is fairly straight forward, and I believe you can leave the other questions blank.
Gail, I have heard a lot of stories like yours. I'm sure some of the erring on the side of caution is to prevent law suits ... but it also does make sense if they don't have other guidance. Still, all the more reason to discuss these issues with our loved ones. At least if our families know what we want, they have some guidance when these situations arise. I know your mom was lucky to have such a strong medical advocate in you, Gail.
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