Transitions: Creating a Beautiful Earthly Departure
As human beings, we will all make our transition from this earth school. This topic is often met with a great deal of uncertainty, angst and avoidance. Having these discussions when we are well and of sound mind regarding things such as withholding various medical treatments, resuscitation, and end-of-life care can be challenging; but it doesn’t have to be.
As a registered nurse with over thirty years of experience I have been witness to some beautiful transitions, and then, there were those that could have been much different if things were thought about, discussed and considered before the individual reaches that pivotal moment when hard choices have to be made.
While this program will discuss the laws concerning these issues, we will spend time reviewing what it means to be a person and how to create a beautiful person-centric transition in a way that is unique and creates meaning for the individual and those they love. This full day program will:
Identify what it means to be a person and to have care and services that are person-centric
Understand the importance of making advanced care planning decisions before health issues arise
Review state specific regulations and documents pertaining to the advanced care planning process
Identify treatment interventions that may occur when advanced care planning directives are absent
Outline how to create a meaningful transition beyond timelines, medicine and geography
Indicate strategies to broach such delicate topics with loved ones
Creating Peace, Joy & Comfort
Resources
Dr. Christopher Kerr, MD and medical director for Hospice Buffalo shares how those close to dying get comfort and closure from others that have gone before them. This beautiful TEDx Talk provides comfort for those left behind.
Dr. Atul Gawande, MD explores death, dying and why even doctors struggle to discuss being mortal with patients. Based on his best selling book, Being Mortal, this Emmy-nominated documentary is a wonderful resource for patients and families who struggle with terminal conditions.
Thinking about death is frightening, but planning ahead is practical and leaves more room for peace of mind in our final days. In a solemn, thoughtful talk, Judy MacDonald Johnston shares five practices for planning for a good end of life.
Advanced Directives Recognized in New York State
Advance directives are an important part of planning for the future. Few of us want to think about what would happen if we or a loved one were in a devastating accident or incapacitated by advanced illness. Yet it’s recommended that everyone over the age of 18 have a written plan in the event of a sudden illness or injury. Advance care planning affords you the opportunity to plan for future medical care in case you are unable to make your own decisions. It’s very important that you choose your agent(s) wisely, executing your wishes is what they are charged with doing. You’ll want to be sure they will be able to carry out that very important role.
Advanced Directives Guide created by the Attorney General.
Health Care Proxy - is the written document that designates a person as your health care agent when a doctor determines that you have lost capacity to make decisions for yourself. It also allows written statements about desired medical treatment decisions in advance.
Living Will - A living will is a written statement of your specific health care wishes in the event you become unable to decide for yourself. New York State does not have a standard living will form. New York State does recognize living wills as valid if they provide "clear and convincing evidence" of the person's wishes.
Medical Orders for Life Sustaining Treatment (MOLST) - contains specific doctor's orders that apply to all healthcare settings, including the person's home. It is a way of documenting a person's treatment preferences concerning life-sustaining treatment. Under State law, the MOLST form is the only authorized form in New York State for documenting both nonhospital do not resuscitate or DNR and do not intubate or DNI orders.
Do Not Resuscitate (DNR) - a medical order issued by a doctor, at your request. The DNR tells medical staff not to provide CPR (chest compressions) if your heart stops. A DNR order does not mean the withholding of all medical care, only CPR. DNR instructions can also be made known in a health care proxy or a living will. It is very important to discuss DNR with your doctor.
Power of Attorney (POA) - a legal document that gives one person (known as the "agent") the authority to act for another person (known as the "principal"). Typically you use a POA if you can't be present to take care of a financial matter, or if you want someone to be able to take care of your finances in the event you become incapacitated. A POA can also be executed for medical needs. A POA that continues after the principal becomes incapacitated is known as a "durable" power of attorney. A POA that does not become effective unless and until the principal becomes incapacitated is known as a "springing" power of attorney (which by its nature is also durable).
Having the Conversation
Planning your final days is never easy, but it's an invaluable gift to your loved ones. These discussions can be among the richest and most intimate that friends and family share. We know that when there is a meaningful conversation about end-of-life choices, survivors report feeling less guilt and less depression while having an easier grieving process.
Thinking through these issues before a medical crisis arrives will help you and your loved ones make decisions based on what you value most, without the influence of stress, guilt and fear.
Your Conversation Starter Kit - developed by the Conversation Project is designed to give people a jumping-off point for this all-important talk and to assist them to keep it going over time as circumstances and life events occur. There are many valuable resources and videos on the site to assist you.
