Posts Tagged ‘DNR’
Discussing End of Life Care (Part 2)
In part one of this two part series, we looked at the different types of advance directives people can establish to ensure that their end-of-life care is in line with their wishes. Today, we look at how to talk to your loved ones and encourage them to express their wishes so that as they approach the end of their life, you as the caregiver know exactly how to proceed.
Although there are always different techniques for approaching this conversation, there does seem to be one common opinion: the time to do it is now. “Everyone over the age of 18 should have a health care proxy form filled out and should be discussing what they would want done with a person that would be making decisions for them in the event that they are not able to make these decisions for themselves,” said Fern Wasserman, Founder of New York Legal Nurse Consultants. New York Legal Nurse Consultants helps facilitate conversations between the individual filling out their health care proxy form and the people who will need to carry out these wishes in the event this person is unable to make their wishes known.
Colleen Reynolds, President of Edge Communications and former admissions and marketing coordinator of a skilled nursing facility in Fort Myers, Fla., also emphasizes that time is of the essence. “I’d suggest that the Healthcare POA/Surrogate be discussed well in advance of needing it. A DNR should be gently discussed, but discussed again when the decision is imminent,” she said. “I watched so many people struggle with this decision and family members who wished desperately that loved ones asked for a DNR after they had been resuscitated and then left to suffer brain damage and broken ribs.”
In Reynolds’s work, she had to have these conversations with patients who did not have any advance directives on file. “Because the conversations didn’t happen earlier, it was often left up to me to talk to someone who was admitted, if they were not declared legally incompetent, to see if they wanted to be resuscitated in the event of heart failure. Strangers should not have to do this.”
Discussing End of Life Care (Part 1)
Erin had been caring for her aging mother for the past four years as her body slowly succumbed to cancer. She had read every book and article she could find to teach her what to do throughout the various stages of care. As she stood face to face with an intensive care unit doctor, who wanted to know at what point they switch from attempts to prolong her mother’s life to giving her only palliative care to make her comfortable as she neared her final days, she became unsure of what to do. Over the past months, the exhaustion from battling the illness had gotten extreme; her mother was only awake for about an hour a day – and barely cognizant of her surroundings for that hour. Erin could not remember the last time she had gotten out of bed. Erin was faced with a tough decision… “If only I had talked to my mother about what she would have wanted,” Erin thought, recalling so many times over the past years where they had pretended that an end would never come. Instead of trying to enjoy every moment left in her mother’s life, she is spending it instead worrying whether her decision is really the one that her mother would be comfortable with.
Although Erin’s story is fictional, it is a reality for many caregivers – a situation that could be avoided with one conversation. While discussing end of life care may sound like a daunting encounter, it does not always need to be.
Before having the conversation, it helps to become familiar with what the different options are, and what is legally recognized in each state. This way, the adult child can be more confident in the information they are bringing to their parents, which will help comfort them and allow there to be fewer “what if’s” that may prevent the parents from opting to make a decision.