The information in this blog is based on current Texas law. Please do not consider them as legal advice.Find out the laws in your state. This blog is just an introduction to documents you may want to consider starting. Your doctor’s office may have most of this information.
Advance planning for end-of-life is beneficial to you and your loved ones. It benefits you by making sure you get the care you want and may need. For your family, it relieves the burden from them of making your life-care decisions. Family members often fight over what care they think is best for you. It’s best that you decide for them.
Living Will (Directive To Physicians, Family, Surrogates)
An executed Living Will is used if you are unable to make your medical treatment preferences known to physicians. It has specific check-boxes about what medical treatment you would prefer. I think this form limits your medical options since medicine is constantly advancing. What you specify may be obsolete by the time you need to use the document. For example:
You fill out your Living Will stating you do not want treatment for a coma.
If you have a head trauma which causes your brain to swell, treatment might call for a medically-induced coma [to prevent brain damage.]
If you have specified you do not want treatment for a coma, that option cannot be used.
Advance Directive (Medical Power Of Attorney)
With this document, you assign a person to be your Agent. You may have more than on agent (a Primary Agent and Alternate Agents.) They have the authority to make your medical decisions when you are unable to do so. Because the Agent has total authority over your medical care, it is essential you keep your Agents apprised of what prognosis you would accept and what medical care you want in different situations.
My Directive has a Primary and an Alternate Agent who will make my medical decisions if I cannot. Neither is related to me but have known me for years. I assigned these two as my Agents to avoid family disputes over my treatment. I keep both Agents apprised of my wants, so they are always up-to-date. As medicine advances, I can tell them what procedures I would approve. With both a Primary and an Alternate Agent, you have two people to back-up each other in case there are disputes amongst family members.
Do-Not-Resuscitate (DNR) and Out-Of-Hospital DNR (OOH-DNR)
Both of these documents prevent life-saving care, and they are used in different situations.
A DNR is used when you are in a hospital.
An OOH-DNR is used when you are not in a hospital.
By law, medical personnel are required to provide life-sustaining care whether you are in a hospital or not. For example, EMS technicians are required to provide all measures possible to sustain life. If they have proof you have an OOH-DNR, all treatment must stop or never even begin.
You will not receive treatment for the following conditions if you have a DNR or an OOH-DNR:
Cardiopulmonary resuscitation (CPR) – Pushing down on the middle of the chest when a heart has stopped beating to help beat the heart, and breathing into the lungs through the mouth to fill the lungs with air for a person that has stopped breathing and whose heart has stopped beating.
Transcutaneous Cardiac Pacing – Pads put on the outside of the chest so an electrical impulse can be sent to the heart to try to regulate certain irregular beats that could be dangerous to a person’s life.
Defibrillation – An electric shock put through the chest to try to start their heart beating again when it has stopped. Advanced Airway Management – When trained people put what looks like a clear tube into a person’s mouth, when that person has stopped breathing or is not able to breathe well on their own, to breathe for them.
Artificial Ventilation – When trained people use a football-sized bag and a mask that fits over a person’s mouth and nose to push air into the lungs when the patient can’t breathe on their own or have stopped breathing.
If you have declined medical treatment, you may take medication to relieve your pain.
Think this tattoo will work? It won’t.
Tattoos and Medical Alert bracelets for DNR or OOH-DNR do not prevent you from receiving treatment. It must be an executed document. My mother wore a Medical Alert bracelet which said, “See envelope in purse.” The envelope was water-proof and tear-proof, and written on the outside of the envelope was a list of what documents were enclosed: an Advance Directive and an OOH-DNR.
Statutory Durable Power Of Attorney
This document designates an Agent to take care of certain property transactions. This Agent does not deal with your medical condition, but only deals with property (financial.)
Hospice’s goals are to maintain or improve the quality of life for someone whose medical condition is unlikely to be cured. Depending on the hospice provider, the following services may be offered:
Visits to the patient’s location by the hospice physician, nurse, medical social worker, home health aide, and chaplain/spiritual adviser. Some Hospice providers even have musicians who will come play for the patient.
Medication for pain control. Inpatient care may be provided short-term if the pain cannot be controlled.
Medical equipment (wheelchairs, bed, medical supplies.)
Short-term respite care for caregivers.
Physical, Occupational, or Speech Therapy, if needed.
Who pays for this? Medicare, Medicaid, Veteran’s Benefits, and/or Private Insurance. If you cannot afford Hospice, there are usually sliding scale fees, or you can apply to receive funds from donations.
Be sure to check current references of people who have received and are currently receiving services before choosing a provider. I used Hospice for both of my parents. The one for my dad was wonderful. The one for my mom sounded wonderful, but it was unbelievably bad. The one good thing my mom’s Hospice did was send a musician when we requested a ukulele player. The Hospice Chaplain came and played mom’s favorite old time gospel songs. I believe hearing them relieved her grief and pain as much as her medication.