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Message
Living Will - To Give Up or to be a Burden?
Posted on 10/8/12 at 8:05 pm
Posted on 10/8/12 at 8:05 pm
Does anyone have a living will?
I can't get myself to pull one together, although I suspect that it would be better for my family if I did (or would it?). Either I tell them to pull the plug, or I state that by golly I should be kept in a vegetative state forever. There is definitely some gray area of course.
What are some of the legal or family implications of having one or not having one? Anyone have some advice on navigating this?
I can't get myself to pull one together, although I suspect that it would be better for my family if I did (or would it?). Either I tell them to pull the plug, or I state that by golly I should be kept in a vegetative state forever. There is definitely some gray area of course.
What are some of the legal or family implications of having one or not having one? Anyone have some advice on navigating this?
5
Posted on 10/8/12 at 8:12 pm to Bayou Tiger
Get the LW and tell them to cut your arse loose when your done. Not a hard decision at all.
Posted on 10/8/12 at 9:09 pm to Bayou Tiger
My mother has the Alzheimer's gene ... she's been tested. Having to make decisions as a family when HER mother was dying was horrendous and tore the siblings apart. Really.
Not long after my grandmother died (I was 21 or so) my mother made her living will out and made me be a witness to it. She didn't want anyone to feel bad about what decisions were made as they were really hers to be carried out. She addressed life support, feeding tubes, and not sure what else.
That said, I work in healthcare and have seen families totally freak out while mom/dad is coding and despite a living will, the family can override it ...
No one wants to think about it but I'm glad to know what my mom's wishes are now that she's in her right mind. I may feel bad carrying them out but I'll know what she wanted.
Not long after my grandmother died (I was 21 or so) my mother made her living will out and made me be a witness to it. She didn't want anyone to feel bad about what decisions were made as they were really hers to be carried out. She addressed life support, feeding tubes, and not sure what else.
That said, I work in healthcare and have seen families totally freak out while mom/dad is coding and despite a living will, the family can override it ...
No one wants to think about it but I'm glad to know what my mom's wishes are now that she's in her right mind. I may feel bad carrying them out but I'll know what she wanted.
Posted on 10/8/12 at 9:28 pm to Bayou Tiger
I had a similar grandfather story. Wasn't ready to let go of him. Thankfully, mom is RN and knew his wishes and said that he wouldn't want this quality of life. He had a beautiful passing.
Living will is preventing you from holding out past the point of no return. If your quality of life isn't going to be what you prefer, opt out and make sure people know your desires.
specify whether you want artificial nutrition to keep you alive. then decide if you are in a coma with no hope of recovery whether you want extraordinary measures to revive you.
see terry schiavo case
Living will is preventing you from holding out past the point of no return. If your quality of life isn't going to be what you prefer, opt out and make sure people know your desires.
specify whether you want artificial nutrition to keep you alive. then decide if you are in a coma with no hope of recovery whether you want extraordinary measures to revive you.
see terry schiavo case
Posted on 10/8/12 at 10:32 pm to Bayou Tiger
Everyone should have a living will, IMO.
Posted on 10/8/12 at 10:41 pm to Politiceaux
quote:I think I generally agree with you but am having a hard time coming up with that exact directive "if x then y". Thanks for the responses so far, and it will prompt me to do some digging for more examples of living wills to find the one that fits my wishes the best.
Everyone should have a living will, IMO.
This post was edited on 10/8/12 at 10:42 pm
Posted on 10/8/12 at 10:43 pm to DanglingFury
I recently discussed this matter with my attorney who was drawing up my will. I mentioned a living will, however, I also told him why I was against one. I had an elderly friend who was in the hospital after suffering a stroke after a heart cath. (Evidently a piece of plaque was knocked loose when the instrument went thrugh her veins.)
After the stroke, she was still able to speak. She called her daughter one night to tell her she was having trouble breathing but the nurses would not give her oxygen. The fastest family member who could get to the hospital happened to also be a nurse (at a different facility). She was able to straighten out the nurses who misinterpreted a living will to mean no treatment at all! Oxygen was immediately put on this poor elderly patient and she felt much better!
My attorney shook his head affirmatively and then told me of his recent trip to the same hospital when he was admitted for a knee replacement surgery. When the interviewer asked him if he had a "living will", he responded, "I sure do. He then pointed to the lady sitting next to him and said "this is my wife of 40 years and she's also my living will". I have told her my wishes. He then told me for the same reason as to what happened with the elderly lady I spoke of originally is exactly why he doesn't recommend Living Wills.
I do have a power of attorney whereby I appointed two of my family members who have been granted my permission to make medical decisions for me if I am not able to communicate them myself. They know they are to talk to the doctor(s) directly and not the nurses who might misinterpret my final wishes.
Always two sides to every situation....just be careful not to release the living will to ANYONE
Normally a living will is for the doctor to interpret and the patient should be at the point of no return, usually certified by two different physcians. Also, the patient is normally comotose. There is a huge difference is making a fully aware talking patient comfortable and pulling the plug on a comotose patient who has no chances of ever recovering, etc...
After the stroke, she was still able to speak. She called her daughter one night to tell her she was having trouble breathing but the nurses would not give her oxygen. The fastest family member who could get to the hospital happened to also be a nurse (at a different facility). She was able to straighten out the nurses who misinterpreted a living will to mean no treatment at all! Oxygen was immediately put on this poor elderly patient and she felt much better!
My attorney shook his head affirmatively and then told me of his recent trip to the same hospital when he was admitted for a knee replacement surgery. When the interviewer asked him if he had a "living will", he responded, "I sure do. He then pointed to the lady sitting next to him and said "this is my wife of 40 years and she's also my living will". I have told her my wishes. He then told me for the same reason as to what happened with the elderly lady I spoke of originally is exactly why he doesn't recommend Living Wills.
I do have a power of attorney whereby I appointed two of my family members who have been granted my permission to make medical decisions for me if I am not able to communicate them myself. They know they are to talk to the doctor(s) directly and not the nurses who might misinterpret my final wishes.
Always two sides to every situation....just be careful not to release the living will to ANYONE
Normally a living will is for the doctor to interpret and the patient should be at the point of no return, usually certified by two different physcians. Also, the patient is normally comotose. There is a huge difference is making a fully aware talking patient comfortable and pulling the plug on a comotose patient who has no chances of ever recovering, etc...
Posted on 10/8/12 at 10:47 pm to frb1951
Part of the second to the last paragraph vanished. Here's the rest of it:
Always two sides to every situation...just be careful not to release the living will to ANYONE other than an attending physician, and only then at such time as there is no hope and your loved one is not able to talk for himself/herself because he/she is comatose!
Don't mean to scare anyone, it's just that I've seen it happen at a major hospital in Baton Rouge and I would hate to see the same happen to any other patient!
Always two sides to every situation...just be careful not to release the living will to ANYONE other than an attending physician, and only then at such time as there is no hope and your loved one is not able to talk for himself/herself because he/she is comatose!
Don't mean to scare anyone, it's just that I've seen it happen at a major hospital in Baton Rouge and I would hate to see the same happen to any other patient!
Posted on 10/8/12 at 10:56 pm to Bayou Tiger
quote:
Does anyone have a living will?
I can't get myself to pull one together, although I suspect that it would be better for my family if I did (or would it?). Either I tell them to pull the plug, or I state that by golly I should be kept in a vegetative state forever. There is definitely some gray area of course.
What are some of the legal or family implications of having one or not having one? Anyone have some advice on navigating this?
Bayou Tiger,
Please read my two posts above before you make your decision. If I hadn't known what can happen when a patient turns in a living will to a hospital upon admittance, I probably would have done the same thing. It'll be a cold day with 6' of snow in Baton Rouge before any facility gets one from me!
Posted on 10/9/12 at 6:15 am to frb1951
quote:Thanks, frb! I like the concept of clearly stating my wishes but entrusting that to family instead of medical professionals.
Bayou Tiger,
Please read my two posts above before you make your decision. If I hadn't known what can happen when a patient turns in a living will to a hospital upon admittance, I probably would have done the same thing. It'll be a cold day with 6' of snow in Baton Rouge before any facility gets one from me!
I expect that our medical industry will only go downhill from here, with pressure to interpret as liberally as possible to get patients off of the "payroll".
This post was edited on 10/9/12 at 6:19 am
Posted on 10/9/12 at 10:17 am to Bayou Tiger
All anyone in the hospital wants is to know what to do in the event of catastrophe. Ie: lethal rhythm
Talk to your family about your wishes. Ask what their wishes are. As gruesome as it sounds, talk about death so that it isn't such a boogeyman.
As an RN in a level 1 trauma center, I've seen some horrible things made worse by the fact that people won't talk about it and aren't comfortable with it.
Know that there are certain situations that are brutal and no one wants to be in.
For instance, living will and hospice in place with father having progressively worsening mysethenia gravis. Can't breathe.
Pt. is 80 years old and because
the son can't or won't make a decision his father will live on a ventilator and tube feeding for what remains of his life. Compares his dad to Stephen Hawking, "I mean he lives in a wheelchair and still contributes to society"
Basically didn't want to feel like he was pulling the plug on dad
Or "killing his dad". But his dad had the dNR in place, his wishes were known.
I could go on, but understand what you want at the end of your life and communicate it. If you don't then you leave your loved ones to deal with the loss and pain and guilt over what you
Might have wanted mixed with their own guilt fears and wishes
Talk to your family about your wishes. Ask what their wishes are. As gruesome as it sounds, talk about death so that it isn't such a boogeyman.
As an RN in a level 1 trauma center, I've seen some horrible things made worse by the fact that people won't talk about it and aren't comfortable with it.
Know that there are certain situations that are brutal and no one wants to be in.
For instance, living will and hospice in place with father having progressively worsening mysethenia gravis. Can't breathe.
Pt. is 80 years old and because
the son can't or won't make a decision his father will live on a ventilator and tube feeding for what remains of his life. Compares his dad to Stephen Hawking, "I mean he lives in a wheelchair and still contributes to society"
Basically didn't want to feel like he was pulling the plug on dad
Or "killing his dad". But his dad had the dNR in place, his wishes were known.
I could go on, but understand what you want at the end of your life and communicate it. If you don't then you leave your loved ones to deal with the loss and pain and guilt over what you
Might have wanted mixed with their own guilt fears and wishes
Posted on 10/9/12 at 11:23 am to frb1951
quote:
After the stroke, she was still able to speak. She called her daughter one night to tell her she was having trouble breathing but the nurses would not give her oxygen. The fastest family member who could get to the hospital happened to also be a nurse (at a different facility). She was able to straighten out the nurses who misinterpreted a living will to mean no treatment at all! Oxygen was immediately put on this poor elderly patient and she felt much better!
A living will has nothing to do with this situation other than the HCP's were idiots. If you are worried about your HCP being unable to discern what a living will is and when it is applied, then you need a new HCP.
This post was edited on 10/9/12 at 11:34 am
Posted on 10/16/12 at 8:54 pm to rmc
Well, thanks for all of the advice. After going through the process of filling out a living will, here are a few thoughts to close the loop.
1) It was an easier decision for me than I expected, since the living will only comes into effect if you are out of commission and unable to make decisions for yourself. The two situations where you can have them pull the plug is when you are unresponsive and terminal (within six months of death) or unresponsive with no chance of improving. It is not something more difficult like would you want to get some experimental chemo or have your balls cut off or something like that.
2) Since I still want the decision making to be in the hands of my family, and not the health care provider, I drafted a medical power of attorney and a living will. The medical power of attorney states decisions will be made by my spouse or mother or sister in that order. They each have copies of this medical power of attorney and the living will that is to be followed. There is also a copy of the medical power of attorney on file with my primary care physician (not the living will, though).
3) The forms are quick and easy. Both the living will and power of attorney form were free to download in Texas and many other states, were easy to fill out, and did not require a notary. The living will has a bunch of choices on intravenous fluids, blood transfusions, etc, but you can ignore those choices and keep the decisions at a high level if you want.
4) I also got a chance to specify that if unresponsive, I do not want to die at home with hospice (just a personal preference). You can put any caveats you want.
Please consider taking these easy steps if you haven't already. If the unfortunate time comes, it gives me peace to know that my family will not be burdened with those difficult decisions.
1) It was an easier decision for me than I expected, since the living will only comes into effect if you are out of commission and unable to make decisions for yourself. The two situations where you can have them pull the plug is when you are unresponsive and terminal (within six months of death) or unresponsive with no chance of improving. It is not something more difficult like would you want to get some experimental chemo or have your balls cut off or something like that.
2) Since I still want the decision making to be in the hands of my family, and not the health care provider, I drafted a medical power of attorney and a living will. The medical power of attorney states decisions will be made by my spouse or mother or sister in that order. They each have copies of this medical power of attorney and the living will that is to be followed. There is also a copy of the medical power of attorney on file with my primary care physician (not the living will, though).
3) The forms are quick and easy. Both the living will and power of attorney form were free to download in Texas and many other states, were easy to fill out, and did not require a notary. The living will has a bunch of choices on intravenous fluids, blood transfusions, etc, but you can ignore those choices and keep the decisions at a high level if you want.
4) I also got a chance to specify that if unresponsive, I do not want to die at home with hospice (just a personal preference). You can put any caveats you want.
Please consider taking these easy steps if you haven't already. If the unfortunate time comes, it gives me peace to know that my family will not be burdened with those difficult decisions.
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