Five Wishes lets your family and doctors know:
1. Who you want to make health care decisions for you when you can’t make them.
2. The kind of medical treatment you want or don’t want.
3. How comfortable you want to be.
4. How you want people to treat you.
5. What you want your loved ones to know.
https://samaritannj.org/resources/5-wishes-living-will-documents/
An advance health care directive is a document in which a person sets out his or her wishes regarding future health care decisions. These might include consent, refusal to consent, or withdrawal of consent for any care, treatment, service, or procedure to maintain, diagnose, treat, or provide for an individual’s physical or mental health.
Everyone should create advance directives, even if they are young and healthy! Continue to read below for an explanation of the different types of advance directive forms, then scroll down to locate the link to download or print your state's documents.
https://www.joincake.com/advance-directives/
The advance directive allows you to make specific written instructions for your future health care in the event of any situation in which you can no longer speak for yourself. It outlines your wishes about life-sustaining medical treatment if you are terminally ill or permanently unconscious, for example.
https://www.helpguide.org/articles/end-of-life/advanced-health-care-directives-and-living-wills.htm
None of us likes to think about how we would want healthcare delivered to us if we became critically ill or unable to communicate. But it is important to make these essential and very personal decisions – known as advance directives – before needing them.
https://www.inova.org/patient-and-visitor-information/advance-directives-and-making-end-life-decisions
Can my healthcare representative make decisions for me if I am still able to make my own decisions?
https://www.state.nj.us/health/advancedirective/ad/forums-faqs/
More and more people are realizing the importance of having signed Advance Healthcare Directive forms prepared while you're in good health, in case they become unable to make decisions regarding your own healthcare.
https://www.ranchospringsmedcenter.com/patients-visitors/advance-care-directive
The term 'advance directive' refers to your oral and written instructions about your future medical care in the event you are unable to express your medical wishes.
https://wsma.org/advance-directives
A Substitute Decision-Maker is an adult you choose and appoint in your Advance Care Directive to make decisions about your future health care, end of life, living arrangements and other personal matters when you are unable to make these decisions for yourself, whether for a short time only or permanently. The Substitute Decision-Maker(s) must sign the Form and accept their role.
https://www.lawsocietysa.asn.au/Public/Publications/Resources/Community/Advance_Care_Directives.aspx
Advance care planning allows you to make your voice heard so your wishes are followed. You can provide clarity and understanding among family members, your doctor and your health care team.
https://www.healthpartners.com/care/specialty/palliative-care/advance-care-planning-health-care-directives/
Advance care planning is understanding, thinking about and discussing plans for a time when you cannot make your own medical decisions.
https://www.valleyhealthlink.com/patients-visitors/for-patients/advance-care-planning/
The designation of a surrogate decision maker who can articulate and honor your health care wishes if you are unable to do so.
https://health.ucsd.edu/patients/yourhospitalstay/Pages/directives.aspx
You can make an Advance Health Directive (AHD) anytime as long as you are at least 18 and have capacity.
https://healthywa.wa.gov.au/Articles/J_M/Making-an-Advance-Health-Directive
By establishing an advance directive, you can rest assured that you'll receive care on your terms because all the decisions made will be your own.
https://www.sharp.com/services/advance-care-planning/advance-health-care-directive.cfm
An Advance Care Directive is a legal form that allows people over the age of 18 years to:
https://www.sa.gov.au/topics/family-and-community/planning-ahead/advance-care-directives
No one can predict the future. Terminal illness or accidents can strike at any moment, rearranging lives, altering priorities, and taxing health care plans. Advance health care directives can help to mitigate the fallout, for yourself and for your family.
https://www.sevenponds.com/before-death/advance-health-care-directives
An Advance Care Directive can be a useful tool for people to communicate instructions about future health care decisions. This factsheet explains the key legal principles on Advance Care Directives.
https://www.eldac.com.au/tabid/4968/Default.aspx
Do you know who will make decisions about your medical care if you are too sick to decide for yourself?
https://www.sansumclinic.org/health-resource-center/advance-health-care-directive-assistance
When we started our project, it was focused on advance directives for mental health care. That is still the major focus of our work. But we have expanded the website to include more about other types of advance care planning too. We hope you find the website helpful.
http://www.virginiaadvancedirectives.org/
The term 'treatment' includes medical, surgical and dental treatments, including palliative care and life-sustaining measures.
https://www.publicadvocate.wa.gov.au/A/advance_health_directives.aspx
Although you may not like to think about it, there could be times in your life when you are unable to make a decision or properly communicate your wishes on how you would like to be cared for or treated. It could be for a number of reasons including an accident or mental health episode, or an illness or injury.
https://lsc.sa.gov.au/cb_pages/advance_care_directives.phpAdvance Health Care Directive
https://healthy.kaiserpermanente.org/southern-california/health-wellness/life-care-plan/advance-health-care-directive#enableScroll
Who will speak for you if you’re ever too sick to make decisions for yourself?
https://www.scripps.org/patients-and-visitors/making-care-decisions/advance-directives
A health care directive is important if your attending physician determines you can't communicate your health care choices (because of physical or mental incapacity).
https://www.health.state.mn.us/facilities/regulation/infobulletins/advdir.html
California Advance Health Care Directive Form (POA & Living Will), allows an individual to choose an agent to make healthcare decisions on his or her behalf in the event they can no longer make them.
https://eforms.com/power-of-attorney/ca/california-advanced-health-care-directive/
You won’t need a lawyer to make your living will official, but most state do require signing the document in front of two witnesses. In many states, documents must also be signed in the presence of a notary public.
https://www.compassus.com/for-caregivers/advance-directive-forms-for-every-state
People of all ages may unexpectedly be in a position where they cannot speak for themselves, such as an accident or severe illness. In these situations, having an ACD assures that your doctor knows your wishes about the kind of care you want and/or who the person is that you want to make decisions on your behalf.
https://www.hcnv.org/advanced-care-directive-forms
Use our attorney-drafted Advance Directive Form to grant a representative the power to make healthcare decisions on your behalf — ensuring you receive the right level of care.
https://legaltemplates.net/form/advance-directive/
You can use these documents to let your family and doctor know your decisions for health care if you become unable to decide for yourself. You can appoint someone you know and trust as your health care decision maker to ensure that your choice or decision is honored.
https://www.tn.gov/health/health-program-areas/health-professional-boards/hcf-board/hcf-board/advance-directives.htmlHealth Care Directive
https://www.lawdepot.com/ie/estate/living-will-medical-power-of-attorney/preview.aspx?loc=IE&
Advance directives allow for many choices. By completing an advance directive, you can identify treatments you want/don’t want, state your wishes about donating your body, organs and/or tissues at death, outline your wishes about burial and funeral arrangements, and even state your wishes about resuscitation.
https://mainehealth.org/services/hospital-medicine/advance-directive
End of life and dying issues from the Muslim perspective:A set of 6 short audio films talking about End of Life and Dying issues during COVID-19 from the Muslim perspective. The aim of these is to help answer questions of mistrust and misconceptions around people dying from coronavirus, especially admission into hospital.
https://updatebrum.co.uk/c19supportbrum/six-short-audio-films-about-end-of-life-and-dying-issues-from-the-muslim-perspective/
Communication
Difficult conversations – why we need to talk about dying
https://www.multiplechronicconditions.org/palliative-care
PALLIATIVE CARE SHOULD BE AVAILABLE TO PEOPLE EARLIER
Many agreed that the benefits
of palliative care should be
available to people earlier
in the progression of their disease.
From 2012 some studies even showed
increased survival among those
who received palliative care.
There was also a strong desire
to move beyond cancer,
the disease that had defined
the approach of the hospice pioneers.
Areas of further palliative care specialisation
began to appear – in
cardiology,
renal medicine,
stroke,
respiratory disease
and neurological conditions.
The medical model of palliative care was
gathering strength.
Likewise, domains of
‘general’,
‘specialised’
and ‘specialist’
palliative care came
to be characterised
according to the complexity
of the problems encountered
and the skills needed
to address them.
Those who focussed
on palliative care
for older people (‘geripal’)
stepped up to the plate
and paediatric palliative care
gathered its own momentum.
Palliative care according
to setting (hospital or community based)
came to be differentiated.
http://endoflifestudies.academicblogs.co.uk/controversies-in-palliative-care-a-matter-of-definition/
“Most
people who have a life-threatening condition can benefit from
palliative care, whether or not they are having active treatment.
Palliative care helps with personal, social and medical problems
associated with potentially mortal illness, especially pain and other
distressing symptoms. It assists families and carers and supports them
in bereavement. It uses skilled approaches from a trained team, but
often involves friends, family members and the wider community.
Palliative care improves wellbeing and in some instances has even been
shown to extend life”.
(David Clark 18 January 2019 - http://endoflifestudies.academicblogs.co.uk/controversies-in-palliative-care-a-matter-of-definition/)
http://endoflifestudies.academicblogs.co.uk/controversies-in-palliative-care-a-matter-of-definition/
The main disease groups identified as needing palliative care are:
- advanced cancers
- end stage organ failures (heart failure, respiratory disease, renal failure, and liver failure)
- neurodegenerative diseases, such as motor neurone disease, multiple systems atrophy, Parkinson's disease, Huntington's disease
- advanced dementia/Alzheimer's
- https://meteor.aihw.gov.au/
- https://apps.hnehealth.nsw.gov.au/
- https://ahsri.uow.edu.au/
- https://www.wnswphn.org.au/
- Five Phases of Palliative Care
https://www.wnswphn.org.au/ - An episode of admitted patient palliative care may comprise a single phase or multiple phases, depending on changes in the patient's condition. Phases are not sequential and a patient may move back and forth between phases within the one episode of admitted patient palliative care.
http://www.npcrc.org/content/25/Measurement-and-Evaluation-Tools.aspx
The principles of good end of life care are:
- ☛ Effective communication with patients and their families
- ☛ Regular assessment
- ☛ Management of symptom control
- e.g. ensure anticipatory medications prescribed
- ☛ Avoid unnecessary interventions
- e.g. ensuring DNACPR status, the need for ongoing observations/investigations/blood tests reviewed
- ☛ Provision of psychological, social and spiritual support
- ☛ Food/fluids as desired – may be appropriate for comfort even if unsafe swallow. Parenteral fluids may be continued/commenced if appropriate.
https://www.gloshospitals.nhs.uk/documents/9696/Guidance_for_symptom_control_in_EOL_5EI23V1.pdf
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The Psychosocial Assessment in Palliative
Patient’s thoughts and feelings about illness, treatment, and care.
- a. What do we need to know about you and your family to give you the best care?
- b. How do you and your family best receive information?
- c. What is most important to you right now? And as you think about the future? Is this different from what you perceive as important to your family?
Coping with emotions, functional changes, symptoms etc.
- a. What have been the most significant changes in your life?
- b. How does illness and symptoms affect your everyday life?
- c. What does the future look like to you?
- d. What substances (e.g., alcohol, marijuana, opioids, and cocaine) have you used or experimented with in the past? Have you ever used these substances to cope with unwanted feelings?
Cultural influences
- a. How do you understand what is happening to your health?
- b. What cultural or ethnic group do you identify with?7
- c. What is your preferred language? What primary language is spoken at home?
- d. Have you been able to maintain contact with family or friends from your country of origin? Have you any plans for visiting that family now or in the future?
- e. (If appropriate to the patient’s awareness) Where is your preferred place of death?
Social context
- a. Who is your family? Of origin and of creation?
- b. How would you prefer to be addressed? Preferred pronoun?
- c. Where do you live? Do you live alone or with others? Are there timeswhen you think about if/when you need more assistance at home andwhat thatmight look like?
- d. Are you a veteran?
- e. Are you currently employed?
Lived experience of illness, impact on self, others, and quality of life.
- a. Do you worry about the financial impact or how your health expenses will be covered?
- b. What has been the impact of this illness on your work and those important to you?
- c. What or whom are you concerned about with regard to your health?
- d. What have you shared about your illness with family and friends?
- e. Who can help with decision making? Who do you go to when things get tough? Do you have a health care power of attorney or agent? Who might have copies of those documents?
- f. Have you, or those close to you, managed serious illness before? Any recent losses?
- g. (If appropriate to the patient’s prognostic awareness) Have you made funeral or after-death plans? Plans for cremation or burial here or in country of origin?
Suffering and the existential/spiritual domain
- a. Are religious or spiritual beliefs or rituals important to you?
- b. Are you being supported by a spiritual community? Does your illness allow you to still access this support? If not, can this support come to you—in person or through technology?
- c. What brings you comfort?
- d. How does this illness influence your thoughts and relationship to your god or a higher power?
- e. Do you feel at peace?
https://europepmc.org/article/MED/32790573
☀☀☀
