![]() If we begin hospice, will the person be denied certain treatments?.When should we begin hospice care? Can they receive this care at home or at the hospital?.What if we don’t want the treatment offered? What happens then?.Will treatment provide more quality time with family and friends?.What might we expect to happen in the next few hours, days, or weeks if we continue our current course of treatment?. ![]() Remember that the decisions you are faced with and the questions you may ask the person’s medical team can vary depending on if the person is at home or in a care facility or hospital. If you are making decisions without specific guidance from the dying person, you will need as much information as possible to help guide your actions. Are they still able to participate in these activities? Or perhaps they loved the outdoors and enjoyed nature. What were their values and what gave meaning to their life? Maybe it was being close to family and making memories together.Have they expressed an opinion about someone else’s end-of-life treatment?.Have they ever talked about what they would want at the end of life?.If you are making decisions for someone at the end of life and are trying to use one of these approaches, it may be helpful to think about the following questions: This is an example of the best interests decision-making approach. After talking with Wadi’s doctors, Ali believed that surgery, which could cause additional pain and discomfort, would not improve his father’s quality of life. But, Ali thought, “What kind of time? What would that time do for Dad?” Ali decided that putting his dad through surgery and recovery was not in Wadi’s best interests. Wadi’s doctor suggested that surgery to remove part of one of Wadi’s lungs might slow down the course of the cancer and give him more time. He is in a nursing facility and doesn’t recognize Ali when he visits. Ali and Wadi’s storyĪli’s father, Wadi, is 80 years old and has lung cancer and advanced Parkinson’s disease. This is an example of the substituted judgment approach. He declined, and his mother died peacefully a few hours later. Joseph remembered how his mother disapproved when an elderly neighbor was put on a similar machine after a stroke. The doctor asked Joseph if he wanted that to be done. The doctor said damage to Leilani’s brain was widespread and she needed to be put on a breathing machine (ventilator) or she would probably die. Joseph’s 90-year-old mother, Leilani, was in a coma after having a major stroke. These two approaches are illustrated in the stories below. This is sometimes combined with substituted judgment. Another approach, known as best interests, is to decide what you as their representative think is best for the dying person. Some experts believe that decisions should be based on substituted judgment whenever possible. ![]() One is to put yourself in the place of the person who is dying and try to choose as they would. Two approaches might be useful when you encounter decisions that have not been addressed in a person’s advance care plan or in previous conversations with them. Decision-making strategies: Substituted judgment and best interests Hospice staff can help determine whether a medical condition is part of the normal dying process or something that needs the attention of health care personnel.įor situations that are not addressed in a person’s advance care plan, or if the person does not have such a plan, you can consider different decision-making strategies to help determine the best approach for the person. ![]() If end-of-life care is given at home, you will need a special out-of-hospital order, signed by a doctor, to ensure that emergency medical technicians, if called to the home, will respect the person’s wishes. If the person has written documents as part of an advance care plan, such as a do not resuscitate order, tell the doctor in charge as soon as possible. Addressing a person’s advance care wishes This can be overwhelming for family members, especially if they have not had a chance to discuss the person’s wishes ahead of time - or if multiple family members are involved and do not agree. If the person can no longer communicate, you may be asked to make difficult decisions about their care and comfort. You may wonder how you can comfort the person, prevent suffering, and provide the best quality of life possible in their remaining time. You are probably reading this because someone close to you is dying.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |