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Wellness Words: Planning for end of life care

Although we may not want to think about it, at some point all of us will face end-of-life experiences. These experiences may occur as a result of chronic diseases, old age or even an unexpected medical crisis. However, in order to ensure your wishes for end-of-life care are met at any age, it’s important to plan ahead and be prepared. There are many things to consider when planning ahead, but the main focus should fall on the amount and type of care you’d like to receive.

The National Institute on Aging discusses several types of emergency treatments used for medical care in times of crisis including:

∫ Cardiopulmonary Resuscitation: If your heart stops beating or your breathing stops, healthcare professionals use CPR to restart the heart and lungs. This requires pushing on the chest with a lot of force, blowing air into the lungs and use of electric shock, also called defibrillation. According to the NIH, CPR can result in broken ribs or collapsed lungs, and is often not successful for fragile, older adults with several chronic conditions. If you decide you do not want CPR as part of your medical care, you must have a DNR or ‘do not resuscitate’ order on your medical file.

∫ Ventilator Use (breathing machines): If you are unable to breathe on your own, a ventilator, or breathing machine can be used to push air into your lungs to help you breathe. Breathing machines can be very useful in short-term emergency situations, but may only make the dying process longer for those nearing end-of-life. If you decide you do not want ventilator use as part of your medical care, you must have a DNI or ‘do not intubate’ order on your medical file.

∫ Gastric or Nasogastric Tubes (feeding tubes): A feeding tube may be used to provide your body with nutrients if you are unable to eat or drink on your own. A gastric tube is inserted into the stomach while a nasogastric tube is inserted through the nose.   

∫ Comfort Care: Comfort care, or hospice care, is medical care provided during near-death circumstances in order to relieve pain and suffering.

When considering such treatments, it’s important to think about your own personal values. Do you wish to get the most days out of life or would you rather focus on quality of life? It’s also important to take into consideration your overall health. If an emergency was to occur, are you relatively healthy or do you have several physical ailments? If you are getting older, what do you picture as a “good death?” Once you have thought about the type of care you’d like to receive in either emergency or near-death situations, it’s important to write out your wishes in an advanced directive.

The National Institute on Aging defines an advanced directive as a legal document that outlines your healthcare preferences and only goes into effect if you are debilitated and unable to speak for yourself. Advanced directives are not set in stone and can be changed at any time.

There are two main parts to an advanced directive including a living will and a health care proxy. A living will lets healthcare professionals know your decisions for care and how you wish to be treated in emergency situations. A health care proxy is a legal document that names someone to make medical decisions for you if you are unable to do so yourself. A healthcare proxy can be anyone, such as a family member or friend, but this person should be aware of your wishes.

One way to ensure your family and friends carry out your wishes is to talk to them. Though it may not be an easy topic of discussion, making your wishes known can provide you with peace of mind and take some stress off of your loved ones.

If you would like to learn more, attend a special program on ‘Advance Directives’ presented by the Rev. Bonnie Orth, Littauer’s pastoral care coordinator on Wednesday in Littauer’s Auditorium.

You are invited to join us for a buffet-style luncheon at 11:30 a.m. for $6 or attend the presentation only at noon at no charge. To attend, call HealthLink Littauer at (518) 736-1120 or email healthlink@nlh.com. We’re your community health and wellness service of Nathan Littauer Hospital and Nursing Home.

Alicia DeRuscio B.S., is a community education assistant at HealthLink Littauer

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