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
- Medicareinteractive.org
- nolo.com Legal website with info for each state
- FloridaHealth.gov You can get a DNR form for FL here. Just make sure to print it out on yellow paper!
- Fivewishes.org Helpful tool in planning advanced directives
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! ❤️
Awesome topic.
I am so thankful that when my brother died from septicemia a complication from dialysis, he had talked to me about his end of life feelings. It’s hard to tell the doctors to stop care and you feel like your the reason someone has died, but it was what he would have wanted. My siblings were in agreement when I told them how he felt. So our family was able to honor his last wishes.
He was in his early 40’s, he probably didn’t think that would happen to him. You really never know. Thank you Staci, maybe it will help someone else have an easier transition. I would not have wanted to make that decision without his input.
Having this conversation when someone is well is the best time to have it.
Thank you for sharing your story, Mary! 😊