Living wills..

katwoman7755 · Aug 17, 2005

The hospice you work for should have information to give the patient (and you for that matter) re: how to execute a living will.....There are some very simple forms such as the 5 wishes book...which is basically a pamphlet that the patient can fill out (it's pretty self explanatory) and then have notorized. The social workers you work with would be a good resource for this...and should really be telling your patients about this option. Living wills can also be drafted through an attorney. You must also note the difference between a living will and a DNR...not everyone who has a living will wants to be a DNR...and depending upon what the laws are in your area, it could greatly affect your patient if all these options are not fully discussed....for instance, when I was in Florida, and say EMS was called by the family b/c maybe they panicked....if EMS could not see easily the yellow DNR, they were obligated to code that patient...they don't have time to look for the living will. Ideally these issues need to be discussed and settled long before they need to be....it is better if the patient can make their wishes known... and it is often times easier for the family not to have to make such hard decisions.

Kathryn RN CHPN

karenG · Aug 17, 2005

hi

thank you for replying.

I dont work in a hospice. I am a nurse practitioner working in General Practice - a FNP I think you would call it.

As far as I aware, living wills are not yet common place here in the UK. its not a topic I am too familiar with. most of the research seems to be American. Its not something social workers get involved in either over here. there is no legislation.. and no handy booklets I can refer to! I feel as if I am flying blind and making it up as I go along........... maybe I am!!

I dont know what a DNR is.........

Karen

madwife2002, BSN, RN · Aug 17, 2005

hi karen

DNR means Do Not Resusitate. Which i will have tatooed on my chest, one day.

kay :rolleyes:

karenG · Aug 17, 2005

hi karen
DNR means Do Not Resusitate. Which i will have tatooed on my chest, one day.
kay

oops........silly me! :imbar

should have known that..............but it is 18yrs since I worked in hospital...........thats my excuse and I'm sticking to it!!

Karen

letina · Aug 17, 2005

Karen, you might get some useful info about this from Age Concern. They provide guidance and fact sheets about Advance Directives and Living Wills.

Tina :)

Katillac, RN · Aug 17, 2005

hi
firstly- i'm sorry if this has been answered before but its new to me...
i'm now working with end stage copd patients (aiming to keep them at home for as long as possible) and i am trying to find information about living wills. its not something i have much experiance with (ok none)
my question is
is there a standard accepted format for a living will? i've run a few searches but come up blank.
help! please.
karen

hi, karen!

i wasn't sure if our laws were the same as yours, so i did some research. your mental capacity act of 2005 (there may be others) seems to give people the right to decide when they are of sound mind what medical care they want when they are no longer able to make or express decisions, and have those decisions stand as if they were making them at the time of care delivery.

aging: advance directive for health care

that's a link to information about pennsylvania's requirements concerning advance directives, but they are similar in all the states. some have special forms one needs to use, but in all states if these wishes are communicated to one's md, the provisions of our law absolve the md from liability if he or she follows the directives. one writes up in layman's terms what one wants, one has two witnesses and a notary sign it, it's delivered to the md, and it's valid. as one poster says, an attorney can also be engaged to draw up the document, but it is no more or less valid.

typically, people address issues such as whether they wish resuscitation or intubation or "heroic measures", and at what point they wish the measures stopped. they may address whether they want artificial hydration and nutrition, whether they want antibiotic therapy, and when they want those measures stopped. they may outline whether they want to be medicated aggressively for comfort even if it means their life may be shortened. they may indicate where they want care given and by whom.

aging with dignity - five wishes

concerns the five wishes booklet referred to. it's one of many formats that are used to help people organize their thinking around end of life care, and in fact life long care if the person becomes incapable of making his or her decisions or making them known.

notably, here in the states we also have the right to designate a health care proxy, someone to whom we give the right to make health care decisions on our behalf when we are no longer able to make and/or express them. documentation of that decision can be included in the living will, or it can be a separate document.

a dnr, on the other hand is a do not resuscitate order signed by a doctor which absolves the emergency team of the requirement to deliver cardiopulmonary resuscitation efforts, including classic cpr, defribulating, and intubating. this is required by the emts in order to not initiate those efforts because it is not open to interpretation, it's a simple one page document and most importantly it's a doctor's order.

i can't help you in researching what format if any you are legally required to use in the uk; perhaps there's a better researcher here than myself who can help. you are welcome to message me if you like with other questions. good luck to you and congratulations for bringing this standard of excellence in planning to your patients.

kat

madwife2002, BSN, RN · Aug 17, 2005

oops........silly me! :imbar
should have known that..............but it is 18yrs since I worked in hospital...........thats my excuse and I'm sticking to it!!
Karen

Ha ha I think we used to say NFR or not for the three 222's more years ago- no worries I think I am in July at the moment.

kay

karenG · Aug 17, 2005

oh thank- you Kat...

thats a tremendous help. I'm great on respiratory care.. but hadnt a clue where to start looking.. so now I have a start point!

Kay.. youre right .. we used to say NFR or not for 333!

Karen

jsteine1 · Aug 18, 2005

There are fill in the blank kits available in office supply stores and online, but there are some twists to the laws in some states. For myself, I had mine drawn up by an attorney so that all the state specific clauses were there.

cowboy94 · Aug 23, 2005

hi
firstly- I'm sorry if this has been answered before but its new to me...
I'm now working with end stage COPD patients (aiming to keep them at home for as long as possible) and I am trying to find information about living wills. its not something I have much experiance with (ok none)
my question is
is there a standard accepted format for a living will? I've run a few searches but come up blank.
help! please.
Karen

Hello - There is a website: http://www.caringinfo.org where you can download state-specific advance directives/living wills for free for all 50 states, hope that helps.

babynurselsa, RN · Aug 24, 2005

You can also go to your state Bar Association web site and they have the forms that you can download and print off. They are very simple plainly stated just initial the appropriate box, No I do not want any resus.

I know that is where we downloaded the ones that we provide for out patients at the hospice that I work for.