Hospice Workers Can Help With Last Wishes

Do you want to end your days tied up to medical equipment without a chance to recover? Many have watched as other people have made the decision to “pull the plug” on loved ones after years of medical care and expense. If you do not want to put your loved ones through this trauma, the best thing to do is to work with a hospice to make sure your last wishes are known.

Why do you need to involve a hospice? A report in the November 1998 issue of RN Magazine stated that without the advantages of hospice care, the outcomes of last wishes were highly reduced. In a survey conducted by that magazine of 743 hospital-based RN’s, 26 percent “have seen a physician or other health care provider deliberately disregard an advance directive. 47 percent [of respondents to the survey] have seen the patient’s family do the same…Among those respondents working in critical care – the [Intensive Care Unit or Critical Care Unit] – that number jumps to more than half.”

Unless you are involved in a sudden accidental death, you may die from a terminal disease or from old age. In the two latter cases, hospice care can help to assure that your end-of-life decisions are respected. But, they can help only if you create a DNR, or a “Do Not Resuscitate” document, an advanced directive, a PMDD and/or a Durable Medical Power of Attorney.

Many varieties of DNR orders exist, and some may create conflicts within the family. For instance, you may agree to choose a medical intervention that involved oxygen or medication, but eliminate CPR (Cardio-Pulmonary Resuscitation). If your family members disagree with your wishes or if you believe that some family members might interfere, it is best to seek legal advice from a professional attorney who practices in this law area. An attorney can help reassure you that your last wishes will be honored.

Only a “Durable Medical Power of Attorney” will authorize another person to make decisions in the place of the patient when you are unable to communicate your wishes (due to a coma or other cause). If you still are able to communicate your wishes, you then always retain the authority to make your own decisions. When you create a Durable Power of Attorney specifying who can speak on your behalf, and specify in detail what your wishes actually are, your wishes are more likely to be carried out. This way, family who may have been unaware of your wishes are less likely to interfere.

An advance directive tells your doctor what kind of care you would like to have if you become unable to make medical decisions (if you are in a coma, for example). If you are admitted to the hospital for illness or surgery, the hospital staff will probably talk to you about advance directives.

The PMDD (Protective Medical Decisions Document) is a protective Durable Power of Attorney for Health Care which is available from the International Task Force. It is a document in which you name someone you trust (a family member, close friend or hospice care worker) to make health care decisions for you if you ever become permanently or temporarily unable to make such decisions for yourself.

If you do not create documents that detail your last wishes and a family member calls the EMS when you are at the point of death, the EMS personnel may be legally required to perform CPR even though you are in hospice and “ready” to pass away. Performing CPR on a terminally ill patient may be extremely painful to the patient and emotionally upsetting for the family.

When you make decisions ahead of time by filling out advanced directive forms, a PMDD or DNR forms to clarify your wishes, you have a legal chance to have your last wishes honored. has You can change your forms at any time, simply by making your wishes known or by re-creating those documents. And, by choosing a hospice care worker as a person to help you meet your last wishes, you can avoid using a family member or a friend as a person who must make tough decisions as they honor your requests.

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