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Debbie Sharp Loeb, teacher by training but full-time mom to a disabled son, craftsperson, bead artist, great cook, creative homemaker & terrific spotter of cool new products for everything under the sun, presents Hodgepodge: recipes, household hints, stories about children, friends & relatives, cool stuff, music, & much more.

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Thursday, May 26, 2005

A-Pass-Along (Advanced Medical Directives)

The following is an email I received from Sally Edwards, a Hospice Chaplain. It had such good information I requestion her permission to post it in full.

Hi Debbie,
I hope you will find an opportunity to say more about
Advanced Medical Directives. You mention "DNR/Living Will". These are two separate documents. Hospitals, at least in NJ & PA where I have worked, are required to ask whether a patient has signed a "Do Not Resuscitate" order.

A "Living Will" allows an individual to state what kind of
treatments s/he does and does not want in the event that
s/he becomes unable to communicate.
It is important to hand- carry a Living Will every time
one enters a hospital for treatment. This document does have
limitations, however; it cannot cover all combinations of
symptoms, and doctors would rather err on the side of
prolonging life, even when doing so requires using
"extraordinary measures".

By far the most important document we all need is a Durable
Power of Attorney for Health Care (or, Proxy Directive, or Medical Power of Attorney). This document appoints someone, in fact, a sequence of someones as health care representative to make decisions about medical care in the event that we cannot speak for ourselves. It includes the information in the Living Will and only becomes effective when we cannot speak for ourselves. Writing a Durable Power of Attorney for Health Care appoints someone with whom the doctors can dialogue and goes a long way to reducing friction among family members.
We naturally shrink from writing a DNR, whether for ourselves or for a loved-one. It can seem like giving up: giving up expectations that medical intervention will be effective, and giving up hope for continuing the life that God has given. In fact, resuscitation is a brutal process; ask a nurse who has been part of one, and there are circumstances in which it is not appropriate.
I prefer to use the acronym, "AND" for Allow Natural Death,
which can be a grace-filled gift to the seriously ill patient.

Which brings me to hospice care. Hospice care is palliative care, that is, it is focused on alleviation of symptoms rather than on using aggressive treatment to seek cure. It is too bad that some patients, and some doctors, reject hospice care because they see it a admission of failure or, defeat.
But that is a topic for another day.

My goal here is to urge everyone to write a Durable Power of Attorney for Health Care. Forms are available free from State Medical Societies, and from hospice organizations.

Sally Edwards, hospice chaplain


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