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View Diary: Why End of Life Counseling is Imperative (256 comments)

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  •  Using "Advance DIrectives" and "Living Will" (5+ / 0-)
    Recommended by:
    sc kitty, CParis, Leap Year, codairem, Olon

    assistance would be a MUCH preferred title for your diary.

    These have traditionally been the 'jargon' of the Medical-Legal Community.

    Using these words makes a considerable difference in the way people approach the issue of advance planning for 'end of life' decisions. "End of Life" plays right into the deathers "pull the plug on G'ma" rhetoric.

    Not only should you have them, you need to provide you Doctor/Doctors with a copy to be placed in your 'chart' [medical records]. You should also keep a copy that you can give to EMTs and the Hospital for emergencies. Do Not Resuscitate orders are also necessary if that is what you want.

    You should also have POAs drawn up in advance. In my parents case My brother was given the POA for financial decisions with me as alternate. I had a separate POA for medical decisions with my brother as alternate. The docs also were given a copy of the Medical POA papers.

    Because of the way our family was, my mom and I talked the need for this over. It was pretty easy at this point, since I worked with 'end of life' care, and my mom had always been pretty vocal about 'no tubes for me'. She then talked to my dad. Then it became a three way discussion which advanced to included my brother. From there the 4 of us did the legal-doctor part.

    "...fighting the wildfires of my life with squirt guns."

    by deMemedeMedia on Thu Aug 13, 2009 at 08:12:20 AM PDT

    [ Parent ]

    •  Hear hear (5+ / 0-)

      "End-of-life counseling" is a poor name that is easily twisted into something sinister.

      Silvio Levy

    •  i'd like a "Do Not Resuscitate" (2+ / 0-)
      Recommended by:
      deMemedeMedia, Linda in Ohio

      tattoo on my chest so that ER staff or EMTs wouldn't have to waste time on me.

      •  EMT's do not recognize "do not resuscitate" (1+ / 0-)
        Recommended by:
        elmo

        in their protocol.

        If you don't want to be resuscitated, leave instructions that emergency personnel are not to be called.

        If you want to avoid someone having to make the same decision multiple times, don't call 911.

        The normal condition of the elderly is variable.  It's not unusual to have bad times followed by good--i.e. the human body has a strong propensity towards recovery, if it's at all possible.
        Caretakers need not to panic.  The elderly do that easily enough.  What they need is reassurance that they are well cared for, even when they fall into temporary dementia--a common occurrence.  The brain shutting down seems to be a survival strategy.  The brain uses up a lot of energy which may be better utilized healing other organs.

        How do you tell a predator from a protector? The predator will eat you sooner rather than later.

        by hannah on Thu Aug 13, 2009 at 10:05:25 AM PDT

        [ Parent ]

        •  Depends on which EMT where (1+ / 0-)
          Recommended by:
          hannah

          My daughter is an EMT and she has described (in general terms, not breaking confidentiality) calls to homes where the patient was in hospice and had a DNR order, and it definitely made a difference in how they handled the call. (She's in a small town, so they can get on the phone with the treating doctor, not like an anonymous big-city call.)

          The issue with DNR requests is sometimes not knowing whether it was actually signed by the person who they're treating. Or if it's a doctor's order, is it authentic etc.

          DNR orders are most useful in hospital or other institutional settings. And they need to be backed up with a Power of Attorney (Health Care Proxy).

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