You have the right to direct your own healthcare and/or name someone else to make healthcare decisions for you entirely or with noted exceptions/limitations. Regardless of your age or health condition, it is helpful to appoint a power of attorney or have a living will in the event that you are unable to make healthcare decisions.
Living Will/Medical Power of Attorney
A witnessed and/or notarized legal document. Appoints an individual to make healthcare decisions should you not be able to do so, or immediately upon signature of the document. A "durable power of attorney" is an individual who can make healthcare decisions for you if you are incapacitated.
Unless you specify "exceptions" or "limitations", your appointed power of attorney will be allowed to:
Consent/Refuse any care, treatment or medical service
Select/Discharge you from healthcare institutions/providers
Approve/Disapprove of diagnostic tests, surgery, medications, orders to resuscitate
Hold/Withhold artificial nutrition
A living will also allows for designation of a physician to have primary responsibility for your care and addresses issues such as organ donation.
Keep the original copy of your healthcare advance directives in a safe but accessible place. Make copies for the appropriate individuals involved, i.e. your physician, power of attorney, family members, etc. You may choose to keep a copy in your medial chart.
You are able to amend or change your advance directives at any time by completing a new document and you are also able to revoke it.
Communication
Death and dying are often difficult to talk about. However, without addressing these issues, individuals and family members often come into conflict with prolonging or ending one's life. It can be helpful to communicate with your family, appointed power of attorney and your physician about your healthcare needs. It is equally important to talk to the involved members of your family and to your physician about what you consider to be an acceptable "quality of life".
Medical Issues to Consider when Discussing "Quality of Life"
Cardiopulmonary Resuscitation (CPR) is used as an attempt to restore heart function and breathing in the event of cessation. This can be done with mouth-to mouth and chest compressions and/or with an electronic defibrillator.
Do-Not-Resuscitate (DNR) is a written physician's order instructing health care providers NOT to attempt CPR in the case of heart/lung arrest.
Total Parenteral Nutrition (TPN) provides liquid nutrition to individuals incapable of maintaining appropriate caloric intake via mouth. Feeding tubes can be through the nose or directly to the stomach/upper intestine. Intravenous hydration is sometimes necessary when a person is unable to orally intake sufficient fluids to maintain life.
Sometimes narcotic pain medication may involve side effects such as changes in mental status and may even hasten death. Individuals with terminal illnesses may prioritize comfort and pain relief even if it compromises their overall health.
Also known as "comfort care", "hospice". Is a multidisciplinary (nurses, physicians, social workers, psychiatrists) approach to achieve and maintain the best quality of life available for the terminally ill patient. This may involve artificial nutrition and pain management and can occur in the patient's home or at a hospice facility.
Intubation is when a tube is placed through mouth or nose to into the windpipe to maintain an open airway for breathing. Mechanical ventilation is a machine which can support or replace the breathing function of the lungs. It can be used for short term respiratory problems or with irreversible respiratory failure.
Life sustaining treatments, "life support", include treatments that replace or support necessary bodily function. CPR, mechanical ventilation, artificial nutrition and hydration, dialysis are all considered life sustaining treatments.
