"I'm too young for a living will"

Nurses General Nursing

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  1. Do YOU have a living will?

    • 23
      Yes! I want to reduce stress on my family, and reduce my chances of spending years brain dead on a tube feed..
    • 1
      No, "i'm too young"
    • 37
      Not yet, but realize i need one, even if i am young
    • 0
      Why would *I* need one? I am not terminally ill, and car accidents don't happen.

61 members have participated

(this is copied as it was becoming a derail on the "Slow Code" thread).

Some ppl think a living will = self DNR order. Many ppl seem to think of living wills as something old ppl should do, but young ppl don't need one.

which is a sad misconception, but a common one.

A living will can state ANYTHING!!

You can have a complete algorithm, with all various scenarios,

and state what you want done in each of those kind of situations.

~A sudden, unanticipated cardiac arrest in some recovery room? Oh yeah, code me!

~I am verifiabley brain dead on a vent for 3 days, don't code me, remove the vent, remove the tube feed.

~I want everything done, no matter what, even if brain dead, code me, code me, code me.

I don't know the specifics of the case you were involved in, (a nurse stated living wills are ignored by doctor)

but, possibly, the person's living will stated they would want to be changed to a DNR in the event ______blahblahblah_______.

Or, perhaps, the patient and doc had some conversation, and the pt's verbal instruction to the doc trumped his earlier living will.

no idea. But IF IF IF the doc DID make pt a DNR, and pt's living will stated he wanted "code me, no matter what"

then

the family can have the DNR rescinded and have pt made a full code again, based on the pt's living will. (that might not be the wisest, most compassionate thing to do, but, with a living will, that IS an option)

I am kind of disappointed, how many NURSES on this forum

are stating remarks that seem to indicate they view themselves as too young,

or it's too early in their life,:no:

to get involved with a having a living will for themselves......

AGAIN, ALL TOGETHER NOW---------------A LIVING WILL

IS NOT NOT NOT A DNR ORDER.

NOR IS IT A REQUEST FOR FULL CODES, either.

EVERYONE'S LIVING WILL CAN BE DIFFERENT from anyone else's living will.

Each of us,

might have different criteria for what WE want done.

A LIVING WILL

SIMPLY STATES

WHAT *YOU* WOULD WANT DONE

IN VARIOUS SCENARIOS.

In your living will-----------

YOU CAN REQUEST FULL CODE NO MATTER WHAT.

YOU CAN REQUEST FULL CODE UNLESS_______(whatever you want here)_________. (you do NOT NOT NOT have to wait til you are 80 years old to write this out, kids!!)

YOU CAN REQUEST TERMINATION OF TUBE FEEDS, VENTS, ETC, in the event you are certifiably brain dead, or whatever criteria you want.

You can request tube feeds and vents be left in place for eons, and full codes daily til the full codes fail, even if you are certifiably brain dead.

whatever YOU want done, is what living wills are about.

Verbally telling your next of kin IS helpful, and great idea,

but THAT might not necessarily always be enough. Remember Terry Schiavo.

You ppl who think you are "too young" to get a living will,:no:

might be inadvertently causing future stress to your next of kin by not having one. Car accidents happen.

Also, get living wills on all your loved ones, too.

Like i said earlier, i also enlisted my most assertive pal to be my "medical power of attorney" in the event i can no longer speak for myself. She knows my wishes,

and would go to bat for me. She's also perfect, because she is both a lawyer, and a nurse and my best pal, and very assertive yet would be so compassionate to my family, she knows them all very well, too.

My family would, indeed, waffle, and leave me on the vent, i know they would, bless their hearts. They would.

so i chose my pal. My family has been told of my medical POA, and of my wishes, so they wont' be shocked when Bev pulls the plug on me, ha ha.

By taking even half an hour,

most ppl CAN avoid causing their families extra suffering, and can prevent their own selves from being that tragic brain-dead victim being kept "alive" with vents, tube feeds, etc.

My living will allows 3 days brain dead, just to give my family time to 'get it', cuz, i know how they are.

lol.

In my state you just choose whether or not you want to be an organ donor when you get your driver's license. Is it not like that everywhere? The back of my license has a blurb about being an organ donor that I've not paid attention to, but I know there's a little heart "icon" on the top of my photo which means I told them at the DMV when asked that I wanted to be an organ donor.

Not that I'm wishing more work on nurses, but it would be kind of nice if there was a fill in the blank type of living will that was an automatic process for being admitted into the hospital rather than just asking, do you have one?

Asking if a person has a living will, is now a normal part of admissions to the hospitals i've worked in. If the person says "No", that automatically triggers an offer to have some dept come by and help person fill one in. I've forgotten now, what dept did that. Maybe social services, but, i'm not sure.

still, a lot of peole don't take up the offer,

cuz

they think a living will equates to "do not resuscitate.".

*sigh*

Obamacare's offer to pay for/cover everyone to have that doctor office visit, specifically to learn about what a living will IS,

was what falsely labelled as "death panels"....this only added to some ppl's false perception that a living will IS a 'DNR' order...(the bulk of someone's medical bills often happen AFTER a code, wowza, ka-CHING!!, and/or in final year or two of a terminal illness..so the cost would having insurance companies cover people all having a doctor visit specifically for finding out about what they want in THEIR own personalized, individual, living will, would have paid for itself, as, no doubt, some would have opted "no code if i am terminally ill, or brain dead" and "no tube feeds if i am brain dead" etc.)

When I was doing C&L psych at a large urban teaching hospital quite a few years ago, I saw the hospital honor advanced directives and POAs that were handwritten on notebook paper -- as long as it was in ink (not pencil), and signed and witnessed, that was good enough. The hospital's position (although I'm sure this is not universal :)) was that you didn't have to pay an attorney to draw something official up; as long as the hospital could determine clearly what your wishes were, and that they were really your wishes, that was good enough.

It is interesting how much variety there is in what is accepted, from one hospital to another, and from one state to another.

This also varies occasionally, from one doc to another, too. I can't recall ever seeing a doc order 'DNR' when the nurses were like, "No way, that pt is so viable!!"

but, i can recall this one doc we had, who almost never ever would write a DNR order, no matter what. That was about 15 years ago, he was kinda different.

but, yes yes yes, everyone should at the least, tell their family their wishes, but, a written living will is better,

and a medical power of attorney is even better, imo. I've seen brain dead, or terminally ill ppl "living" on vents, tube fed, who probably never ever would have chosen that.

Specializes in LTC and School Health.

Wrote my living well at 21 but haven't gotten it legalized yet. I need to get started on that, life is too short. Lord knows I don't wanna be trached, peg, and left on a vent.

Wrote my living well at 21 but haven't gotten it legalized yet. I need to get started on that, life is too short. Lord knows I don't wanna be trached, peg, and left on a vent.

GOOD ON YOU!!

I'm not sure if the links in reply #13 and reply #15 are accurate, but, if they are, then apparently, in some states, just signing it in front of 2 other people is all that's required. But, so worth checking on to be sure!!

This is an excellent topic. I've actually had a living will since I was 22 (I'm 27 now). I was taking a medical ethics course, and I came to a personal realization that it was necessary after reading several case studies.

You are never too young to have a MPOA and a living will. Those nurses who think they are too young need to go work Trauma for a while. A real eye opener for sure. My husband and I discussed on more than one occasion about what he wanted done as he got sicker and if he was no longer a transplant candidate. It was to take him home. We had an advance directive in place. It amazes me that in the light of a terminal illness and an advance directive how much the medical establishment will still try to push dialysis, intubation, pressors etc. on families. I was at home when the doctor told my husband he was unlisted. When I got back to the hospital I requested to see the resident. I insisted that she make him DNR/DNI at that point. She said "well we have to discuss it" I told her no discussion was necessary and to write the order. She hemmed and hawed and I finally told her that if I went to get something to eat and I came back and they were coding him, there would be hell to pay. It got written. The nephrology resident came in to discuss dialysis. I asked the resident if it came with a liver and she said no. I sent her packing. Then she had the fellow come in and once again I had to shut him down too. He needed dialysis 3 days prior! So why then? What part of DNR/DNI didn't they get?? It's all about the money honey! We had insurance and this was a University hospital (that's another story) I shudder to think if one of his kids or his mom was his MPOA. Long story short you certainly need a MPOA that will hold their ground as far as what you want done.

I think it is a sign of maturity that younger people think about these issues and plan before having their families thrown into the medical maelstrom.

As a 25 year old diagnosed with a brain tumor a year ago last week at the ripe age of 24 I realized there were quite a few things I'd never thought of...like short term disability for instance :rolleyes:. Obviously I didn't have a living will at the time of diagnosis either but between the diagnosis and the major 10 hour brain surgery a week later I did put together some advanced directives and get them notarized. Working in an ICU there are just too many scenarios I have seen and never want happen to me to risk it. My dad actually suggested I do it, I was hesitant but then realized it was probably a good idea. Thankfully my surgery went fine but you just never know.

Specializes in Clinic NP.

I really didn't read most posts, but had to mention...

If anyone really says they're too young; ask them if they wear a seatbelt, use a fourwheeler, or ride a motorbike.

Just saying... 5 years in surgery; all my trauma activations were due to one of those... not saying it doesn't happen, but of those trauma surgery pts, never saw seatbelt marks. ;)

Specializes in retired LTC.

While you're doing the papers with a lawyer, finish the process with your final will (not just the 'living will'/adv dir/MPOA). You can change it if cicrcumstances change for you later. And for some, you should consider a life insurance policy to help pay for some left over bills and/or funeral expenses. (Sheesh - I sound like that TV commercial!)

Had all my paperwork done some 15 years ago after my Mom went critical - without her documentation. She did recover and then subsequently had it all taken care of, along with that of my Dad who could not make the DNR decision by himself at the time she was so sick.

There's no Mr. amoLucia or any little amos in my life; both my parents have passed away. I just want it quick and easy for my sisters to proceed re my end-of-life wishes and to have access to all my vast worldly possessions. I don't want any long-lost faux relative to contest anything.

As experienced nurses, I believe we have all seen way too many tragic horror stories. Some of us, personally, have been only an eyelash away from being one of those stories. Life IS too short; OnlybyHisgrace said it very well.

Specializes in LTC, assisted living, med-surg, psych.

Here's a twist: when I filled out my POLST (physician's orders for life-sustaining treatment) form at the age of 50, my doctor told me I was 'too young'!! Especially because I'd chosen to be a DNR. I looked at him and said "Look, we've both been in codes and we both know how all that works. I don't want that for myself. If I've still got a pulse, sure, go for it....but if I'm dead, for God's sake LEAVE me that way." He signed the order.

Here's a twist: when I filled out my POLST (physician's orders for life-sustaining treatment) form at the age of 50, my doctor told me I was 'too young'!! Especially because I'd chosen to be a DNR. I looked at him and said "Look, we've both been in codes and we both know how all that works. I don't want that for myself. If I've still got a pulse, sure, go for it....but if I'm dead, for God's sake LEAVE me that way." He signed the order.

Good on you, Viva, for getting YOUR wishes on paper, this will help someone else someday, further on down the road. I kind of almost see doing our own living wills, as an act of kindness, helping out someone ELSE who will be faced with tough choices know what we'd want done.

It's always an option to have the DNR be conditional,

such as "I'm a DNR if i am terminally ill/end stage disease process"

or,

"I'm a DNR if i am certifiably brain dead."

etc. Probably many docs would balk at a wide-open, general DNR on a young person, but, a conditional DNR is something we can stipulate even decades before the criteria IS met, even when we are very young, we can have it written, and our medical POA be told, "I'm a DNR if i am _____" (whatever criteria each individual wants put in there.)

Specializes in orthopedics, ED observation.

I know this is a super old thread, but I'm looking at major surgery in a few days. You can bet your sweet bippy that there will be an advance directive in place and a DNR order on my chart...

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