Last week, I was consulted by a patient who wished to discuss their wishes for end of life care, but did not know how to bring up the subject with their families and care takers. Because this can be a challenging and emotionally filled conversation, often family members are not aware of the wishes of their older loved one.
It is common medical practice to ask elderly or terminally ill patients about their wishes if they were to be taken to the hospital at a time of respiratory distress or cardiac arrest. For a younger patient there is no question that everything would be done, including insertion of an artificial airway to help them breath if needed, to give CPR including chest compressions as well as starting an IV to administer medications. An elderly patient near the end of their life may not wish to have all of these measures taken, and may even resent this treatment if it does not coincide with their wishes. Many patients are not aware that hospitals are required by law to undertake resusitation measures unless the patient has a specific order on file.
Talking with a loved one about difficult issues is not easy, but being proactive and listening to their wishes can save frustrations later and give the elderly loved one the peace of mind that their wishes have been heard. It is also easier for family members to accept these decisions and be the proper advocate for their family in times of crisis after this has been discussed in advance.
Many hospitals can provide their patients and their families with a worksheet that can help plan end of life care. If filled out in advance and posted in a convenient location such as the refrigerator, it can be easily accessed in an emergency at a time when ambulance staff arrives to take the patient to the hospital. State-specific advance directives can be downloaded on the National Hospice and Palliative Care Organization (NHPCO) Web site.
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO