Important things everyone needs to do

[I_WANNA_BE_ATP]

To the moderators, I'm sorry if posting here is the wrong forum but I need to get this out into the public.

I worked the past 2 days in the ICU of a big hospital. Ones of the things I see on a daily basis is a person not planning for sickness. Here is my point, I took care of a 45 year old lady who we found out had cancerous tumors all over her body (kidneys, lung, pelvis, brain, ribs, spine, and a few more I can't think of). She was quite confused, only knowing her name and nothing else. Basically, she is imcompent to make her own decisions Her live-in boyfriend of 20 years, was there but legally he was useless to the medical staff. Florida does NOT recognise common law marriage. She did not have living will or a durable power of attorney !!!!! SO legally we couldn't tell him anything, not blood test results, X-ray results, treatment etc. We had to call her brother in another state to get permission to do special xrays and biopsys.

From past experience I know that, no one wants to think of their death. No one is truely prepared for this situation. BUT 2 very important pieces of paper need to filled out, regardless of age or health. They are a living will aka advance directive and a durable power of attorney. These papers lets the medical personnel taking care of you know what you want done in case you are unable to do so for many reasons, confusion, coma state, etc. This is the 3rd time in the past month I've had this problem, to some extreme.

The forms are easily obtainable and don't need to be that specific. You can download the forms here:

www.abanet.org/aging/toolkit/home.html

or

www.uslivingwillregistry.com/forms.shtm

Please it only takes a few minutes and please discuss end of life care with your loved ones. Makes it easier somewhat and avoids fights at the bedside between siblings (been there, got the black eye).

Thank you for letting me vent some frustrations!!
I now return you to you dreams of flying through level 5 thunderstorms wondering what would Doug do ????

[AlexF]

Good Point!
It is very important for each and every person to have an AD AND a power of attorney for healthcare. Two other pieces of advice:

First, discuss your wishes with those on your power of attorney, say what you want, what you care about, and what to do if x happens. Don't shy away from the subject, it is important.

Secondly, my advice (and only mine, not legal advice of any sort, just an opinion) is to not say something along the lines of "keep me alive if there is a chance of survival." This has led to numerous problems because most any situation can technically have a chance of survival and you could be a vegitable, draining your family of money for years because there is a slight chance you may still live. Discuss it with your family and tell them when it's o.k. to slap a DNR on the chart.

It's better to do it now, so they are prepared, then have them guess and wallow of the decision when it's to late.

[aviatorrbt]

Great point. Thank you.

[I_WANNA_BE_ATP]

Thank you Alex for adding your valid points. I thought to say something discussing your decisions with your loved ones. What's kinda funny is that my ex-girlfriend is my DPOA. Not my family. I chose her because she is also a nurse and we have discussed what we will allow and not allow to be done, and when to pull the plug.

[My Flight Surgeon]

I agree with the posts. This is IMPORTANT to everyone. There is nothing more depressing than to see someone existing on tubes and a machine and know from previous conversations that this is not the way they would want it. It has to be VERY CLEAR to your DPOA for Healthcare what your wishes are.

The other point here is simple. If you have an attorney draft these legal documents, keep them seperate. I have seen cases where the financial and health POA's were in the same document and for some reason the individual "changed" the health POA thus voiding the financial POA as well.

[Kristie]

isn't your spouse your legal DPOA, even when there are no documents???

[tonyw]

Originally Posted by Kristie

isn't your spouse your legal DPOA, even when there are no documents???

Nope. Remember Terry Schiavo?

[I_Money]

For the doc, and I Wanna Be ATP - where do DNRs fit into this?

I have seen people who are dying be resuscitated and I do not want that, however there are also stories of lives being saved with no long term complications from resuscitation and I definitely would like that! How is all of this defined? Should I sign a DNR or not?

Also, one of the vets at the old equine hospital used to tell owners - 'if it was my daughters horse' it really put it into perspective. I would feel awfully guilty putting my parents through tough decisions like that - it is compounded by the fact of all the complex information they will have to decipher, make a decision based on, and then live with that decision. Is there a way you can get the ethics committee, team of doctors, nurses into the equation. I have heard many doctors comment about quality of life, doing procedures on patients they would not want done on themselves etc. I would much rather pass this to a team of professionals (even though they are strangers) who understand the situation, the possible outcomes, and make the decision what is best for me (takes the hope out and makes it reality!).

[I_WANNA_BE_ATP]

Originally Posted by I_Money

For the doc, and I Wanna Be ATP - where do DNRs fit into this?

I have seen people who are dying be resuscitated and I do not want that, however there are also stories of lives being saved with no long term complications from resuscitation and I definitely would like that! How is all of this defined? Should I sign a DNR or not?

Also, one of the vets at the old equine hospital used to tell owners - 'if it was my daughters horse' it really put it into perspective. I would feel awfully guilty putting my parents through tough decisions like that - it is compounded by the fact of all the complex information they will have to decipher, make a decision based on, and then live with that decision. Is there a way you can get the ethics committee, team of doctors, nurses into the equation. I have heard many doctors comment about quality of life, doing procedures on patients they would not want done on themselves etc. I would much rather pass this to a team of professionals (even though they are strangers) who understand the situation, the possible outcomes, and make the decision what is best for me (takes the hope out and makes it reality!).

Each situation is different, so I'm not even going to armchair quarterback that one.

When it comes to a DNR and QOL issues, I always tell the family to get together, get some coffee, and discuss what their loved one would want in a situation like this. Even if their loved one doesn't have a living will, the family members (I hope members, it gets complicated when it's one person), get to talk about what their loved one wanted. Case in point, My dad says he doesn't want to be on a ventilator but yet will NOT sign an advance directive. But my brothers and sister know his wishes, he's told us many times.
I cringe whenever a medical professional has to use the "pressure" tactic of "if it were my family member"... I feel that is unprofessional. When family ask me "if it where your mother...." I say, this is not my decision, it is yours, and then try to help guide them.

There should be an ethics committee at every hospital. Just ask the nurse to get them together. It's a very easy process. If the hospital for some reason doesn't have an ethics committee, then you can ask for care conference. The family meets with all the doctors, the nurse manager, and a social worker. This meeting should include all the doctors giving their input on prognosis, care options, etc.