Personal Directives

[260 Rem]

For those who don't have one, there is no better time than now to decide how you want things to be handled in the event you are ever physically or mentally disabled to the point that you need someone to make your health care decisions. Templates are available on-line, and IMO, are a good framework on which to customize your instructions. Make sure your instructions are clear. This would be an appropriate thread to perhaps share some "tips" regarding language/ideas you would include in such a document.

[gpgriz]

Ya... Mom and Dad have 'em. And we've sat down to read and discuss together.
The discussion is in important part.

[alacringa]

I have one, and have made sure that my bro will be willing to carry it out.

[Sooner]

I think this is a great idea and most families should do this and then discuss so all know what the others are thinking long before a health incident happens. I know I have wanted to do this since my dads by-pass 2 yrs ago. No time like the present.

[omega50]

You can go as a family to the Kerby Centre for an info session

[jhfong]

Make sure you read the online forms as to who CAN'T sign as a witness. I was told last week that people often come with the form improperly signed, and the form is therefore invalid and won't be accepted by the hospital or care facility.

[260 Rem]

Here are some excerpts from my PD

"Any agent appointed by me shall have full authority to interpret all personal and medical issues as they relate to me and the instructions given hereafter".

Any agent appointed by me, may make personal and health related decisions related to myself, should my physical or mental condition be compromised to the extent that I cannot make those decisions for myself.
I further direct that any agent appointed by me, shall have the right of access to my personal medical information and treatment programs commencing the date this document is signed.
If at such time a situation arises in which there is no reasonable expectation of recovery from severe physical or mental disability to a state of meanibpngfull interaction with friends and family, I direct that I be allowed to die and not kept alive by medications or artificial means. In particular, I request the following directives be followed:
1. Measures of artificial life support, in the stated situation, that I refuse are:
*CPR and admittance to an intensive care unit
*Mechanical respiration when I can not breate myself
*prolonged gastric tube or intervenous feeding when I am indefinitely unable to eat through my mouth
*Antibiotic medication to prevent infection.

2. I authorize the donation of any of my usable organs after my death.
3. I wish to have medication mercifully administered to me in order to avoid suffering even though this may shorten my life.

[3blade]

Great thread idea, these decisions need to be made well in advance. It is incredibly difficult for family to make a decision in the heat of the moment.

260: Some words of advice: "reasonable expectation" does not have a consistent definition. This phrase has caused issues many times. The rest of your directive is quite clear, and would likely be followed.

AHS has a form called a "Goals of Care order" it uses alpha numeric codes, each linked to a series of care options that are very clear and well known throughout the healthcare system. It must be discussed with your physician, signed by said physician, and presented to EMS or ER staff immediately. Electronic record of this form is available in hospital, however resuscitation decisions are not delayed if the form is not immediately available for the attending physician.

Essentially, have it with you. "At home" isn't good enough. Resuscitation won't be delayed for paperwork or contacting family.

[bosshog]

Great advice. I think Personal Directives/Wills etc are often overlooked, especially for younger people. We try to get ours out every couple years and update it to make sure it is current and all directives are up to date with our current situation. Hopefully nothing ever needs to be executed until its my time but better to be safe than sorry and have to have a grieving wife/family member have to make decisions on your behalf.

[Selkirk]

. . . This would be an appropriate thread to perhaps share some "tips" . . .




Cookie-cutter, off the shelf, personal directive (PD) forms are inexpensive and convenient, but most are not worth the paper they're written on. They often don't stand up in court, and many doctors refuse to abide by them.

Going through the very important process of setting up a PD, is not the time to cheap-out! It will cost you more, but a personalized PD done up properly by a lawyer is by far, the best way to go.

Mac

[260 Rem]

[QUOTE=3blade;2740084]Great thread idea, these decisions need to be made well in advance. It is incredibly difficult for family to make a decision in the heat of the moment.

260: Some words of advice: "reasonable expectation" does not have a consistent definition.

Thanks 3b ... can you suggest a phrase that might be more appropriate? Do you think the preface that the agent is authorized to "interpret" all terms in the PD would answer any questions??

[3blade]

[QUOTE=3blade;2740084]
Thanks 3b ... can you suggest a phrase that might be more appropriate? Do you think the preface that the agent is authorized to "interpret" all terms in the PD would answer any questions??

It's a question of timing:

Either you wish to be resuscitated, or not. No paramedic and few ER physicians will decide whether or not you have a "reasonable" chance in an emergency. That discussion usually happens after you have been resuscitated and placed on a ventilator, with multiple tests to determine your likelihood of survival. The physician then discusses things with your agent, as they now have clinical information to make a "reasonable" decision. however there is the possibility of resuscitation preserving vital organs and brain stem function, with the loss of cognition. So discontinuing efforts at that point may not result in death.

If you are ok with this, keep it as is. If you don't want those treatments started in the first place, take that wording out, but realize you may die from an entirely reversible condition. Between a rock and a hard place.

Hope that clears it up.

Disclaimer: I'm not providing medical advice.

[260 Rem]

Thanks again 3b ... we all understand we are just sharing "tips" from an entirely personal perspective. I am certainly OK with the senecio you describe. My thoughts are more focused on the decision that would be made ... say by a long term care facility ... to send me to an ER.