Monday, June 25, 2012

Roadmap to living the way you want near end of life

Finding your way without a roadmap makes the journey long, inefficient, confusing, frustrating and sometimes painful. A clear map and planning can avoid anxiety and wrong turns. Let's begin by providing just such a roadmap for the questions that may arise if you become ill. Keep in mind that this roadmap can be changed at anytime as long as you are able to do so mentally.
Treat, not to treat , how and how much to treat are the ethical questions that need your guidance.
In order to be treated the way you want, your wishes have to be known ahead of time since you may be too ill to do so later.
Although most states have official Advance Directive forms which you may have already completed, these forms tend to be long, cumbersome and difficult to understand and interpret and thus most people are reluctant to complete them.
This all can be simplified in a one page document if we focus on how we want to live and establish minimal goals of living as far as our mental and physical abilities go!
Once these are established , your physician would know how to take care of you , when to treat and when not to treat.
These can be added to your advance directive if you already have one. It will enhance it's operative value tremendously.
By taking the time to answer three questions you can provide a valuable roadmap to those around you.
The first two questions  address your minimum levels of mental and physical abilities that you are willing to live with , even if it is with the help of life prolonging treatments.
The third question addresses the types of artificial treatments and support you are willing to accept to help you attain at least your minimum goals of living.
It is advisable to do this in the presence and with the help of your physician/ medical advisor since there can be many nuances to these important discussions .
We will explore these three questions in detail in the near future.

Friday, June 22, 2012

Don't Despair

If you are reading this, it means you may have a need for help in dire circumstances and there seems to be no good alternative. End of life can be very difficult and troublesome in many ways. Patients and families suffer at many levels; physical, psychological, social and spiritual. It may seem that the end will be painful and difficult. If not managed well it may be. But having dealt with hundreds of cases over the last 20 years of my work in this field, I am convinced that we all deserve a good death. It is possible to achieve that if we take the appropriate steps in a timely fashion AND have an understanding, compassionate team of healthcare workers guiding us through.

The first step is to accept death as a normal part of life and prepare for this eventuality proactively.
What you do not want to experience is that you are severely ill and unable to make your own decisions and your family has to decide for your treatment options. This is a huge burden on them and many a times results in conflict among everyone involved. The sad part is that you, the patient , end up suffering unnecessarily.
So, early open and honest conversations with the family are an essential part of your end of life planning, just as you would plan for your assets etc.
Future blogs will give step by step examples and suggestions on how to go about it.