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End of Life Care – Your Personal Directive

We are all heading to a final exit.  Have you considered preparing your family and friends for your departure ahead of the bell?

Do you have a personal directive in place? With it, you guide decision making regarding your health care needs and wishes, when you cannot make those decisions yourself.

  • Do you want to be resuscitated and maintained on life support in ALL circumstances?
  • Under what circumstances would you wish to have a ‘Do Not Resuscitate” order on your chart?
  • Who will make medical decisions for you? Naming someone to do this saves bedside squabbling among family members or friends. And it helps medical care staff know who to talk to about issues related to your care.
  • Always consult the family and friends before making these decisions on your Personal Directive so that they know what was behind your thinking and decision making when you signed the PD. With that you can rest easier and so can those who volunteered to help – those you chose to be your decision makers in the PD.

Have you had this conversation with your family doctor? What do they know about your wishes regarding quality of life as you grow older?

  • What interventions do you want them to take to make your life more comfortable as you age? Pain management, palliative care, dementia assessments should all be considered in advance of the need for them. Talking about them out in the open reduces everyone’s fears. Talking about it with your doctor lets them know you are considering how to age well wisely.
  • Do you want to live fast and die quickly or live well and die slowly? Your physician can advise and help you live better with advice on good nutrition, controlling blood pressure, cholesterol, health and lung health, digestive health, infections and cancer reducing strategies. They help you make good decisions regarding your future ability to live well, no matter how you want to live and die.
  • As you come closer to the end of life, in whatever form it takes, disease, dementia or debilitation, taking care to make decisions in advance, you will have less to be concerned with at this stage. End of life care will be described in your Personal Directive and/or your Living Will.  A Living Will can set out the conditions for withdrawal of life support when you have no chance of recovery from a medical condition including dementia and/or you are reaching the end of your natural life. This involves removing feeding tubes, ventilation support, and intravenous drugs.  All that might continue is continuous pain management.
  • Having a Living Will sets out your wishes in advance, to guide decision making at the crucial  end time.  Sharing a copy of your Living Will with your family, the holder of your Personal Directive and your physician would be helpful so that they all understand your wishes well in advance of the end of your life.  Renewing your Living Will by revisiting it regularly and signing the copy on file with your personal papers, including your Personal Directive, ensures that everyone understands that your wishes did not change over time.
  • Note that in Alberta, Living Wills are not legally binding documents. 

For more information and guidance on creating a Personal Directive, go here.

For more information on choices possible for your Living Will, go here.

For testimonies about patterns with death and dying, see Patterns with Death

There resources provide a beginning for people seeking to clarify their future before the urgency of end of life decisions are upon them and their families. Have the conversation now. Don’t wait until you can’t talk.

 

 

 

Posted in Patient Advocacy

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