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Decisions to Consider for a Senior's End of Life
Lisa Reisman • Aug 28, 2019
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Decisions to Consider for a Senior's End of Life
There are so many things to consider during medical crisis, and the last thing a family wants to do is guess about their loved one’s wishes. Making sure you have a living will prevents your family from having to make these difficult decisions, and provides overall better guidance for what your future looks like when your health becomes compromised.
Importance of a Living Will
A living will is a legal document that lets a person state their wishes for end-of- life medical care. It allows for a patient to have a choice in their medical emergency when they aren’t able to communicate otherwise. A living will can also be referred to as an “advance directive,” or a “healthcare directive.” It is important to consider your values when comprising your living will; you may have to think about some tough and emotional situations that could affect you and the people you love most. Would you want to lose your self-sufficiency and independence? What circumstances would make you feel as though your life is not worth living. Are you willing to undergo any treatment possible to extend your life, with no cure guarantee?
According an article
on living wills by The Mayo Clinic, decisions in a living will include preferences for:
· Resuscitation of the heart when it stops beating. Decide if you would want to be resuscitated by cardiopulmonary resuscitation (CPR) or by a device that delivers a shock to stimulate the heart.
· Mechanical ventilation to take over breathing if you’re unable to do so. Consider if, when, and how long you would want to be placed on a ventilator for.
· Tube feeding supplies the body with nutrients and fluids intravenously or via a tube in the stomach. Decide if, when and for how long you would want to be fed in this manner.
· Dialysis removes waste from your blood and manages fluid levels if your kidneys no longer function. Determine if, when and for how long you would want to receive this treatment.
· Antibiotics or antiviral medications can be used to treat many infections. If you were near the end of life, would you want infections to be treated aggressively or would you rather let infections run their course?
· Comfort care (palliative care) includes any number of interventions that may be used to keep you comfortable and manage pain, while abiding by your other treatment wishes. This may include being allowed to die at home, getting pain medications, being fed ice chips to soothe dryness, and avoiding invasive tests or treatments.
· Organ and tissue donations for transplantation can be specified in your living will. If your organs are removed for donation, you will be kept on life-sustaining treatment temporarily until the procedure is complete. To help your agent avoid any confusion, you may want to state in your living will that you understand the need for this temporary intervention.
· Donating your body for scientific study also can be specified. Contact a local medical school, university or donation program for information on how to register for a planned donation for research.
Importance of Having a Power of Attorney
Having a medical or health care power of attorney usually coincides with having a living will, and means you assign a person to make decisions for you when you are unable to do so. In some states a power of attorney can also be called a durable power of attorney for health or a health care proxy. This person can be a spouse, child, friend, or anyone close to you with your best interest in mind. You may also assign alternatives if your first choice isn’t able to carry out their duties. Your power of attorney will be called on your behalf to act as one of many roles involving your health. A power of attorney will help make decisions as your health care agent, patient surrogate, health care proxy, and health care representative. This person will be important for so many reasons, because even though you’ll have legal documentations regarding your care, not all situations can be anticipated. Your power of attorney will have to use their best knowledge and judgments of you and the type of life you envisioned for yourself, even in the ending stages. They are an advocate for your well-being, and should be made aware of your values prior to your decision of naming them your power of attorney.
Do Not Resuscitate
In addition to creating a living will and assigning a power of attorney, you should discuss the option of having a “do not resuscitate” or DNR order, before an emergency occurs. A DNR order allows you to choose whether or not you want CPR in an emergency. A DNR order applies specifically to CPR, and not to other treatments such as pain management or nutrition— those would be included in your living will. The doctor writes the order only after discussing it with the patient (if possible), the proxy, or the patient’s family. Considering a DNR can be thought about when you’re evaluating the same values you used to put together your living will— how, why, and for how long do you want to prolong your life given the circumstances of your health. We’d all like to imagine a world in which we’ve lived a wonderful, healthy life, and our passing is peaceful and well prepared for. For some, it goes as such, but for others having these discussions before health issues arise can make for a much less stressful time in your life as well as for the people who love you most.
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