The living will movement established a situation on how and where your wishes will be framed - advance care planning - communicating with terminally ill patients
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Advance Directive for Health Care. Do it yourself a health care power of attorney, living will, guardianship and organ gonation provisions document. Designate a primary physician with advanced medical directive |
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Help Doctors with a Living Will
More people are now aware of living wills, then in the past, and they are interested in them, and how they work. This is not the case for elderly patients, who have been hospitalized. For these patients, there is a great deal of confusion about living wills. But they are open to discussion concerning end of life issues. Many of these elderly patients have expressed a desire to limiting their health care in the event they become terminally ill. The question of misunderstanding and a lack of knowledge bring up an important topic. How can we educate and prepare people for the inevitable end of life.
In 1969 an attorney (Louis Kutner) came up with the idea of a living will. It was a response to the paranoid condition that was a reaction to new technology. It imposed upon doctors to use life-sustaining treatment to keep patients alive who were ready to die. The creation of the living will was a document that gave the patient the control on how he or she was to be treated; in the event they become disabled and cannot represent themselves. In the beginning living wills used technical phrases such as hopeless prognosis or heroic treatment. Legislation was passed across the country that gave physicians the power to use health care directives. But the language was so complicated that physicians honoring such directives found it difficult to understand. The development of validated worksheets was created in response to these problems. The living will movement established a situation on how and where your wishes will be framed. There is a series of standards set out by psychometricians that created the formation of topics and the validating of opinions. The purpose of the living will movement was to decide how decisions should be made and by who. Worksheets were designed that could be used in correlation with discussion that would bring about logical decisions. At first the living will movement was interested in curbing aggressive doctors. But patient's wishes soon became the priority. The patient would have the right to control the end of life issues. Through the process of evaluating the options patient will have time to decide and have control of the last phase of their life. Having a trusting friend or relative to be your health care agent and ready to step in is a major consideration. No one likes to talk about the inevitable end of life and the issues connected to it. It has always been a taboo topic to talk about but we are now in a more interactive world where everything is discussed. There was research that concluded that living wills were not fulfilling their intended role. Some believed we should abandon the idea. Meanwhile palliative care services and the hospice movement were becoming more credible. Clinicians were trying to combine both ideas into a practical concept. Advance Care Planning Living wills were adapted so that people in the last stages of their life would be able to make intelligent decisions that would be able to protect them and their family. Discussion is a very important part of advance care planning. Worksheets were designed to facilitate these options. It opens a bridge between the patient, their family, and health care professionals. The document is only a small part of the process.It is important to understand that advance care planning involves discussion, contemplation and reflection, and creating a situation where health care professionals and families can meet. Legal documentation is important and has its place. The goal is to have the terminally ill persons and their families have the best possible experience. Those facing terminal illness would like to leave this world with dignity. They do not want to create a problem for their loved ones. Health care planning at the end of ones life if done correctly, can accomplish this goal. Communicating with Terminally Ill Patients It is rare for physicians or the terminally ill patient to initiate a conversation about health care planning. Only about 50% of patients have living wills or estate planning wills. But there is progress, and room for improvement. We can plan, talk to our families as we approach death. Worksheets can be developed so that meaningful experiences of families and patients can be realized."Help Doctors with a Living Will"
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