End of Life

Healthcare Declarations

Staci2 Comments

In my years as an RN, I’ve seen way too many patients and families left with difficult end of life issues. It’s not a topic most people like to discuss, because let’s face it, nobody likes to talk about death or loosing a loved one. But I do believe it is so very important! This goes along with my last post on aging parents (check it out).


Healthcare declarations are not just for the elderly and sick, either! Legally, 18 year olds are adults when it comes to medical decision making. And only 7% of those 18 to 29 have any sort of advance directive. Most people assume that family members will make decisions on your behalf in the event of illness or injury. Too many times this ends in heartache, confusion, and possibly even in court if members are in disagreement over your care.


Types of Advanced Directives

Advance directives are usually referred to as the combination of living wills and healthcare proxy documents, including durable power of attorney for healthcare.

Living Wills: A living will is your health care declaration, not to be confused with a conventional will or living trust used to leave property at death. A living will states what type of medical treatment you do or do not wish to receive if you are too ill or injured to direct your own care. Ideally, these should be as specific as possible. Directives as to artificial hydration and nutrition, treatments like dialysis and chemotherapy/radiation, and surgeries should be addressed here.

DNR, or Do Not Resuscitate, Order: A DNR order is written and signed by a doctor, instructing healthcare providers not to do CPR if your breathing or heart stops. These are usually done near the end of life or if you have a life-limiting illness. A DNR order does not address other treatments.

Physician Orders for Life-Sustaining Treatment (POLST): A POLST form is like a DNR, but they cover much more. They must be signed by a medical doctor and usually in life-limiting situations (near end of life, or a life threatening illness). They include a DNR order as well as addressing other medical treatments like breathing and feeding tubes and antibiotics. POLST forms are available in most states, although they might have different names (MOST form in NC).

A lawyer is not needed to create these specific documents. It is important, however, to know about laws in your specific state. For example, in Florida, a DNR order must be printed on yellow paper for it to be legally valid. Also, Florida does not have its own form for a POLST yet.

Resources

Here are some books I came across, too, that might be of interest and helpful.





Like I said before, I’ve seen more than enough end of life heartache and despair throughout my career. I’ve seen families ripped apart by decisions and opinions regarding a loved ones final days. I feel like a lot of these situations could have been a tad easier had there been advanced care planning in some form. Or at the very least, some sort of conversation.

Let me know your thoughts on this difficult topic! ❤️