Submitted by HalloweenLover t3_127sj4s in explainlikeimfive
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Submitted by HalloweenLover t3_127sj4s in explainlikeimfive
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Brother: Hmm, you know, dad is being a real smartass lately. And he refuses to help plan the vacation. He just sits there, drinking beer and watching baseball all day. Mom says he won't stop swearing at the preacher, and refuses to help cook like he used to.
Sister: yeah, he sure has become a real burden to us all.
Dad: I’ve made you 3rd in line to have power of attorney, and set the age to 35 before you’ll be eligible to take on the responsibility.
Dad: "I'm right here you fully baked creampies"
It is a great idea to spell this out and good advice.
I don’t like at all this idea of “being a burden” on the family as a criterion for withdrawal of life supporting care. I’m an ICU doctor and almost always the family wants the patient kept alive more than the patient does, as the family loves them and doesn’t want to let them go. But the patient is the one who has to suffer the reality of their quality of life. And many will be in nursing facilities so not a “burden” on the decision maker. In addition it is unlikely the decision-maker would use being a burden as their explicit reasoning.
Focus instead on what an acceptable quality of life means to you. Knowing that they are following your wishes is usually what gives people the strength and love to let go.
To be fair my wife is an NP so she does know quite specifically what I want
My partner and i did our wills a few years ago. We learned a "fun difference". I'm very frugal and I'm the higher income earner with incredible work provided life insurance. My partner is much more of a spender, money burns a hole in his pocket (he responded really well to budgeting and stuff, so its not an issue).
My will was first. We get to death/dying. I told him no extreme measures unless i can return to how i was before "whatever happened" and if my MS and arthritis have me in a wheelchair, absolute DNR. We get to funeral stuff. I hate ceremonies. 3 university degrees and I go to one graduation. I refuse to ever have a marriage and fuck bday parties. So my will says i want to be cremated. That he has to select the cheapest options, with having the crematorium put me in a ziploc bag would be fine. Then just throw away the ashes. I do not care. Just do not waste money on it. My beliefs are very soul based, the body is just a vehicle.
We get to my partner's and the mf-er wants full on open casket, full ceremony, headstone, plot in the graveyard, etc. I told him his life insurance isnt enough to cover what he wants so he better prepay. He just laughs but damn... our one diverging value is gonna get us after death. I assume he fes as uncomfortable with my plan as i do with his.
What you are wanting is an advanced directive. This tells the health team who can make choices for you, if you are unable yourself, and a good AD will say what choices you want made. I really like this one that a local hospital has as a template.
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For clarity:
A DNR is a Do Not Resuscitate. This only applies to if your heart is unable to function enough to keep you alive, do you want them doing CPR and all the things to get your heart going again.
A DNI is Do Not Intubate. This only applies if your lungs aren't able to support you on their own, do you want to be ventilated.
"Pull the plug" usually means that you have already been resuscitated and intubated and you turn off the ventilator that doing your lung's job.
I'm a nurse at a hospital.
DNR is do not resuscitate, so if you have a DNR, and the people around caring for you know you have a DNR, and no one from your family is trying to argue with the DNR, the they will not start CPR/BLS/ACLS (chest compressions, rescue breaths, intubation, defibrillation, meds, etc.) if you stop breathing or your heart stops beating.
A living will is a separate document and you do not need one to have the other, but they often go together as they are typically considered when someone is nearing end of life or has a quality of life compromising condition. A big reason for that, is the more sick or aged you are, the less likely a resucutation attempt will be successful.
Whether you want to be a DNR now or not, discussing your wishes for what kinds of medical care you want should you become unable to make decisions for yourself with your loved ones is a conversation you should have early and at regular intervals. You can make a living will with resources like the 5-wishes or other tools. Or you can designate a MDPOA to make those decisions for you.
Making sure you're family/chosen family knows what you want and making sure they will honor it is more important than any document. Families can and do override DNRs (thanks to a highly litigious healthcare system/country, I'm in the US). If you have documents, make sure your family knows where they are and make sure your primary care provider has them too.
It's super important to note that in the US, no matter what your written DNR -- the form that patients complete while in their soundest minds after a discussion with a physician -- says, it can always be overridden by family who want to "do everything". It is one of the cruelest and most selfish things for people do to their loved ones, but it happens all the time. Anyone filling out a DNR absolutely must have frank and honest conversations with their family members about their wishes before they are incapacitated.
I've always told my family that if they rescind my DNR I will haunt the ever-loving shit out of them.
I signed mine yesterday. It’s part of the medical power of attorney designation in your last will and testament. It’s basically stating your wishes legally in the event you cannot speak for yourself. It allows you to designate someone to speak with the physician on your behalf and follow your instructions regarding situations where you’re terminal, incapacitated, etc. Its a way to retain your rights, you sign over HIPAA so someone can act on your behalf to hold a facility accountable.
A DNR is very specific medical orders. What you’re talking about is more vague than that. If you have a DNR they will NOT resuscitate you no matter the cause or opinions of the medical professionals. Your wish is to not be resuscitated medically and they honor that. Your heart stops and they can’t and won’t do anything. Based on your feelings you do Not want a DNR but should write up a living will and make instructions for your next of kin or whomever you want to have power over these decisions about what threshold you’re willing to go to and what you do or do not want them to do.
Licensed medical practitioners are, somewhat simplified, taking an oath that they will always, always, always try to protect lives and help someone else avoid death.
In some beliefs, it's considered sinful to get medical help instead of accepting that your time has come.
This has created the need for some sort of middle ground gray area.
And that's what the DNR is for. If you tell your hospital that "if my heart stops, allow me to go peacefully", they will attempt to respect your wish to go when it's time to go, instead of attempting to keep you alive.
It's probably a hint mentally complicated for nurses and doctors, knowing that they COULD save someone, if that person actually wanted to be saved.
Also these instructions would be included in your file when you make them.
In fairness a lot of the time have to advocate for people to sign a DNR. There are so many patients who we would rather not work on because essentially we would leave them in a worse state than if they just arrested.
If you want it to be rock solid, put it in writing in a living will is other people have said. But it doesn't have to be this formal. If there are no formal instructions, the healthcare team will ask your family what to do. If you've been clear with your family (and have a good relationship with them) they will be able to relay your wishes to the health care team.
One thing I'm not seeing mentioned here, and I think it's worth noting, is that if you put together any document like a DNR or a living will, it must be notarized before it can be considered legally viable. Just writing "do not resuscitate" on a piece of paper (over-simplifying but you get my point) is not going to mean anything if anybody tries to dispute it.
Best bet, go through a site like LegalZoom to get it put together if you can't afford a lawyer for a will-writing session, and make sure it's all wrapped up with a notary so you don't have to worry about someone making a decision on your behalf that you don't want.
The process/requirements vary dramatically from place to place. There's no one answer to this question.
If you get older and want a DNR, have it tattooed on your forehead! My mom coded after a long fight with SuperNuclear palsey (Dudley Moore) and they grabbed the wrong chart and revived her.
She lived another six months in a vegetative state.
They will ignore a tattoo. You need the actual paperwork on hand
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no, a DNR can often include medical non intervention clauses including no defibrillation. There are also out of hospital versions which include paramedics, caretakers, and EMT's.
>A do not resuscitate order (DNR) is a medical order signed by an adult patient and their doctor ordering that no cardiopulmonary resuscitation (CPR) be performed on the patient in the event of cardiac or respiratory arrest, even if CPR would save the patient’s life. CPR includes cardiac compression, endotracheal intubation, artificial ventilation, defibrillation, and other related medical procedures.
nighthawk_something t1_jefm9c4 wrote
What you want is a living will and an power of attorney who will understand and respect your wishes.
The best way to do this is to write down clear and specific (as specific as you want) instructions and give them to the person who would be responsible for your medical decisions in the case of your loss of capacity. If you're married, this will typically be your spouse, but you can also (in writing) specify a parent or sibling. Just sure to ask that person.
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For example, my wife and I worked out our instructions/will recently.
For myself, I wanted to be kept alive as long as I have reasonable quality of life. I also made explicit wishes that I don't not want to be kept alive should I become an unreasonable burden on my family.
Basically, I made it clear that keeping me alive in a situation where I am a burden is against what I want.