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Advance Directive - Understanding the Basics

Advance Directive - Understanding the Basics

Overview

Do you know what your parent wants when it comes to end-of-life care? Do you know if your mom wants to be put on a ventilator, or what to do in the event your father slips into a coma? Every individual should make their wishes regarding end-of-life care known to their families and loved ones. An advance directive is basically an instruction of the type of care you'd like to receive if you're unable to make medical or health care decisions on your own.

Caregivers of elderly parents should also be aware of what their parents want in regard to care in life-extending procedures. Take the time to write down the wishes of your parents in regard to advance directives or Do Not Resuscitate orders.

Defining Your Parent's Desires

Sit down and talk with your parents about what they wish regarding care in the event of an accident, illness, or disease process that renders them unable to make medical decisions on their own. For example, if your mother slips into a coma, what are her wishes? Does she want to be placed on a ventilator, receive tube feedings, or receive life extending measures such as CPR in the event of cardiac arrest?

If your father has suffered a brain injury due to a car accident, does he want to remain on life support for short or long period of time? Does he wish his organs to be donated to science or to an organ donor program?

Determine whether or not your parent wants to accept artificial hydration or nutrition as a means of life sustenance in the event of a serious illness or coma. Artificial nutrition and hydration is offered through an intravenous catheter or tube inserted into a vein, but may also be inserted through the nose and down the throat, or through a catheter into the stomach.

While the laws and regulations regarding advanced directives are different in every state, caregivers as well as senior citizens should be aware of the need for creating written documents that explain what you want, for both your family members and your doctor.

If your parent has been diagnosed with a terminal illness, he or she may wish to have more control over her death. Advance directives merely specify preferences about medical care before it's necessary, and helps to spare stress on caregivers and loved ones and family members from making life sustaining decisions.

Do Not Resuscitate Orders

A Do Not Resuscitate order is a type of advance directive that specifies that your parent, or yourself, doesn't want advanced lifesaving measures such as CPR to be initiated if the heart stops or breathing stops. DNR orders should be known to every physician providing care and are typically placed inside medical charts in medical care facilities, doctors offices, and in records or charts of all health care providers, and are accepted in all states.

Writing an Advance Directive

Advance directives may be created several different ways, including merely writing down the wishes of yourself or your parent, and having them signed by your parent. Caregivers may also obtain these forms from a parent's physician, through lawyers, or downloaded on the computer, or purchased at office supply stores.

Make sure that the advanced directive(s), regardless which form is used, is reviewed by your parent's health care provider and are understood. After careful review by your parent, his or her primary health care provider and yourself, copies should be made, handed out to other family members as well as your parents health care providers.

Changes can be made at any time, but always make sure that family members and health care providers receive updated copies. These documents may also be canceled, again signed and dated ahead of any life-threatening events.Make sure that advanced directives and Do Not Resuscitate orders are specific, clear and detailed and are signed and notarized according to your state's laws and regulations.

As always please talk with your attorney and/or health care professional before making any decisions about how to proceed.

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