Emily Papile

END OF LIFE DECISIONS

Importance of Advanced Directives

• Some states family isn’t allowed to make decisions regarding life-sustaining treatments without a living will

• Some states require clear evidence of the persons wishes or a legally designated decision maker

• Clearly states your wishes if you are unable to state them yourself

Living Will

• Legal document that allows a person to put in writing their wishes regarding medical treatments for the end of life care, should a person not be able to directly communicate their wishes

• The Living will becomes effective in most states when, a physician certifies that you are unable to make medical decisions and you meet certain conditions that are stated in the states living will law• Terminal Illness

• Permanent unconsciousness

Healthcare Power of Attorney

• Also called Healthcare Proxy or Durable Power of Attorney for Healthcare

• A person of your choosing that is authorized to deal with all medical situations when you are unable to speak for yourself either permanently or temporarily

• Becomes effective when a physician determines that you are unable to make your own decisions

• If a person regains the ability to make decisions for themselves HCP cannot continue to act for you

DNR, DNI & DNH• DNR – Do Not Resuscitate

• Legal document that instructs emergency personnel not to preform CPR in the even of cardiac arrest or respiratory distress

• Needs to be sign by a physician to be legal

• DNI – Do Not Intubate• Legal document that instructs medical personnel not to intubate for life-

sustaining measures (ventilation) in the event of respiratory distress

• Needs to be signed by a physician

• DNH – Do Not Hospitalize• Legal document that states that a patient not be transferred to a

hospital from places like a long term care or home unless needed for comfort

• Needs to be signed by a physician

Important things to think about• Do you want any life sustaining measures taken?

• Feeding tube

• Ventilator

• Where do you want to die?• At home is possible

• In a facility (hospital, hospice house, nursing home…)

• Does my Healthcare Proxy understand my personal and spiritual views when it comes to death and dying?

• Does my Healthcare proxy have similar views as you regarding death and dying?

• Tragedy can happen at anytime, its never too early to start thinking about and discussing end of life care

Common Questions• Can I make changes at any time?• Yes, you can change your mind or make updates for the living will or

healthcare proxy at anytime

•What if I change my mind and no longer want to be a DNR, DNI or DNH?• You can revoke any of these at anytime by notifying your physician

or attending physician and they’ll remove the form from your file

• Is it possible for the physician or Healthcare proxy to not honor my wishes?• Yes, in some circumstances. Its important to discuss your wishes

with both your PCP and the person you appoint as HCP to make sure they understand and will do what you want for end of life care

Works Cited

• "End of Life Decisions." Home. N.p., n.d. Web. 05 Mar. 2014. <http://www.caringinfo.org/>.

• "Glossary of Terms." MOLST. N.p., n.d. Web. 05 Mar. 2014. <http://www.molst-ma.org/resources/glossary-of-terms#dnh>.