Mrs. B died yesterday, her body gone, overcome by pneumonia that has overwhelmed so many is so short a time. She was a wife, a mother, a friend. She was 88 years old. She was on breathing machine for 25 days before she died, a feeding tube in her nose giving her nutrition a big IV in her neck giving her fluids and medication. She has not really had a discussion with her family about her wishes of being on a breathing machine long term. Of course, she may have thought about it, but never got around to speaking about it as well people just want to avoid these things. If she had a Living Will or Advance Directive in place, perhaps the suffering could have been abated.
Living Will or Advance Directives support the patient’s choices to withhold treatments if they should have a terminal illness or there is little to no hope for recovery or quality of life. This prevents them from being on life support unnecessarily for days on end, when the outcome is futile. The document is extremely easy to fill out and does not even need a lawyer, just a person who is alert and oriented knows where he or she is, and 2 witnesses who are not health care professionals. It gives you choices such as to have hydration and feeding tubes, life support or comfort measures, that is to let healthcare providers keep you comfortable with medications and other comfort measures. It is vital to understand first what your wishes would be, then that of your partner. Talk to your partner, parents, even your children. If you are someone else’s health care decider then you should know what their wishes are. Understand how your state looks at legal next of kin. This decides who will be your health care decision maker unless you make this advance directive to designate one. Mostly is goes to spouse, parents, children, siblings, and so on. If there are family difficulties, it is valuable to get things organized ahead of any issue.
If you or a loved one have a terminal illness in which you are expected to live less than a year or any chronic illness where life expectancy is poor, a good idea is to talk to a palliative team. They can build goals of care with you, that you can use when you are admitted to the hospital. You may also use them when you need home health services. These goals of care can help meet your needs and help you and your health care team be on the same page.
Talking about these events or decisions is not easy but communicating these details before an untoward event strikes could save your family grief and stress down the road. Being proactive is the right choice.
