Do you have advanced health care directives?

ktwlpn, LPN · Feb 17, 2015

YES....a copy is on file at my PCP's office

Jules A, MSN · Feb 18, 2015

Great topic and I have been surprised at those of us in this business who don't have one. I have cared for both physicians and nurses without one on file and family members in conflict about treatment. I don't get why this is sometimes considered macabre or taboo.

My mom is going to a home when she can't care for herself. I'll certainly visit but I have no intention of attempting to provide adequate care for her in my home. I have had an advanced directive, used to be called Living Will, since I was in my early 20s. I'm old enough to remember the Karen Ann Quinlan case which really freaked me out as a young person. While I respect everyone's right to have their end of life care carried out however they wish my plan is to get nothing but pain meds, hopefully lots of them. Definitely no food, no hydration and I don't want antibiotics. If a Heimlich maneuver won't fix me leave me alone. What I do want to do is go to the most horrible nursing home in my area with the hope the neglect will hasten my death. The good news is now that I decided I didn't want to go to a nice nursing home I have started to spend all the money I had been socking away for my long term care. :)

amoLucia · Feb 18, 2015

Had my paperwork done 1997 or so. Advanced directives, medical POA and my will. Still need the POLST. Past PMPs, current PMPs and any hospital doing any procedure have a copy of my AD.

I have no Mister or kiddos to make decisions for me, just my siblings. But I want my final wishes and 'estate' to have my directions to save my sisters the turmoil re my care.

In 1997, my Mom becoming seriously ill WITHOUT her documentation being done was my impetus. Family had to make a DNR decision at that time, and that was difficult. After her recovery, she and my Dad had their papers put in order. And I followed.

Like OP and Jules, I don't understand why more healthcare practitioners don't have their AD done. As a nurse in LTC, I freq had to approach the DNR topic with family when serious decline/death was imminent for the pt. The timing for that decision-making then is so painfully difficult, esp if the decision-maker is also elderly. Not to mention if there are multiple family members with different opinions involved. Or unscrupulous family out to make a buck off the pt.

To Jules - I don't think you really want to go to the most horrible NH. While it may be the most neglectful place most likely to hasten your death, it may also be the worst place to consider your need for pain management. Personally, I want to be peaceful, comfortable, la-la happy with a smile on my face.

And I will put out a gypsy curse on anyone who tries otherwise! I will come back to haunt them!

whichone'spink, BSN, RN · Feb 18, 2015

I have a five wishes document. However, I don't have a POA who lives in the country full-time. And I don't have anyone else I could trust. But nevertheless, my would be POA knows that I don't want lifesaving measures such as CPR, dialysis, long-term ventilation, feeding tube, Etc. Even if I had a chance of living with those extreme measures, I don't want it.

HouTx, BSN, MSN, EdD · Feb 18, 2015

Based on my own experiences, I don't actually have a lot of confidence in AD's - seen them overridden too many times in a clinical situation because there aren't really any consequences for physicians if they choose not to follow them. Instead, I have made my wishes crystal clear to my family, along with providing them legal empowerment for them to act on my behalf. This is much stronger because everyone knows - dead people don't sue, but their families do. It's a shame, but this is a fact.

~PedsRN~, BSN, RN · Feb 18, 2015

I have everything written out, to the letter. I had one drafted when I was pregnant with my first daughter - who is now a teenager. They are so important. I tell all my friends, who are nurses - who see this horrible stuff that people do in the hospital to keep their loved ones alive - you better write it all down ! Because grief can make people crazy. And you never know if it's going to be your husband putting that feeding tube in you when you're brain dead.

ETA: and the above poster is right - they aren't the legal end all be all. But I do think they can clear up some unanswered questions. I know it would be harder for my family to go directly against my wishes.

I think what is even more important than a advance directive is a healthcare power of attorney. Get someone you trust. Make them that person. Let them make your decisions and make sure they KNOW WHAT YOU WANT.

OCNRN63, RN · Feb 18, 2015

I have very explicit adv. directives, as well as a POLST. I keep a copy in my purse. My parents have a copy, my PCP has a copy, and my attorney has one. There is also a copy on file with the hospital I usually go to.

OCNRN63, RN · Feb 18, 2015

I also have a POA and a medical POA. I also have a bank POA. Pretty much everything is taken care of. Since I have cancer, when I get to the point that treatment no longer provides quality of life, I will stop treatment and go on hospice. I hope I can avoid being placed in a nursing home.

Jules A, MSN · Feb 18, 2015

I also have a POA and a medical POA. I also have a bank POA. Pretty much everything is taken care of. Since I have cancer, when I get to the point that treatment no longer provides quality of life, I will stop treatment and go on hospice. I hope I can avoid being placed in a nursing home.

This sounds like an excellent plan and I also hope you are able to remain comfortable at home.