End of Life
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End of Life
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Important Issues in
the Your “Job”
in the Death and Hierarchy of the
Dying Living with Spiritual Distress Overview on Death from
a The Role of Culture and Diversity “Real” Intersection of Systems Helping Individuals
Face Important Questions That are Good Conversation Starters Advance Care Planning Durable Power
of Attorney for Helping Survivors Deal With Grief |
Advance Care Planning Advance care planning helps individuals choose care options before they are no longer able to make decisions for themselves. It increases the likelihood that medical care will match the person’s wishes, and decreases the chance of too much or too little treatment. (It is important to help the family realize that decisions made may need to be revised based on the individual’s condition.) Planning also takes away the burden for family members of making difficult health care decisions for their loved ones. And, it can reduce conflicts between family members, close friends, caregivers and health care providers. Older individuals with chronic illnesses might begin to dwell on how they would prefer their lives to end. Often, they yearn for a way to discuss these issues – however, they don’t know how to start the conversation. Others do not feel an urgent need to complete advance care planning because they feel that their family or physician will somehow know their wishes. Either way, a congregational nurse can serve in the important role of initiating compassionate, honest conversations with patients about the realities of the disease, the possibility of dying, and action to take in preparation for death. Some families, too, have great difficulty in planning in advance for care. It always helps these families if they have a trusting relationship with a person who knows the patient and the family, and who has been able to talk about these things ahead of time. You will typically resonate a level of trust and understanding to help families make decisions, and to continue to be comfortable with the decisions that have been made. In addition, you can support families by simply listening to their concerns, and seeing that they are not becoming too stressed or feeling too responsible for the situation at hand. Often, what family members need most is to know they are doing all they can – that the very best thing they can do is not to make the situation different, but to simply give their hearts, their thoughts, their love. Advance care planning usually involves making choices about end-of-life care and completing a legal document – in Minnesota, this is called a Health Care Directive [add link]. The Directive overviews specific information about a person’s preferences, such as: 1) their wishes for health care (ex. whether they want feeding tubes, respirators, etc.); and 2) naming a health care agent(s). The Document combines two legal documents that were used prior to August 1998, the Living Will and Durable Power of Attorney for Health Affairs. Further information about advance care planning can be
found at the following links: The decisions that have to be made are not easy. However, it is vitally important to have specific plans for end-of-life care. For case studies and illustrations of “real life” ethical dilemmas around end-of life decisions, visit the University of Washington School of Medicine Web site, http://eduserv.hscer.washington.edu/bioethics/topics/adcarec1.html. |