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Preparing for the last days

EAGLE COUNTY – There are fewer things in life more certain than dying. We live our lives focusing on everything in between birth and our demise. There is no doubt that is what we should do. Nevertheless, if we think and plan about our final days, we can die with the same dignity, respect and honor that we lived our lives.Dear Doc: A lot of my friends and neighbors haven’t thought about a living will . No matter how old you are, I know how important it is. Could you tell people about living will s?- Thinking About the Future in EagleDear Thinking: Thank you for a great and very important question. If you have assets, and especially if you have children, having a will has likely been suggested to you. It protects all you have worked so hard for and assures that those important to you will benefit from that after you are gone. While there is no doubting the importance of your last will and testament, it is equally important to plan for your last days, weeks and months before that last will is called into effect. While it is easy to think of having a traditional will for those you will leave behind and a living will for your final time here, your family will truly benefit from both. Medical decisions near the end of life are difficult, emotional and frequently come with an urgency stressing an already tense situation. Not infrequently, these decisions are left to family members if your health has left you unable to make them personally. There are actually several documents to consider. Each fulfills an important and distinct role. They include the living will , the health care proxy, the durable medical power of attorney and do not resuscitate order. In that order then:A living will is a narrowly recognized document that supports medical decisions you make in advance of a health condition that prevents you from making them directly. It may cover such important decisions as receiving cardio pulmonary resuscitation, mechanical ventilation to breathe for you if you are unable and even artificial hydration and feedings. It is important to know that a living will only comes into effect under two conditions. The first is of course that you are unable to make or express such decisions yourself. The second condition is that two physicians independently confirm that you have a terminal medical disease or illness.Like a living will, a health care proxy only comes into effect under the same two conditions. The health care proxy identifies an individual and usually an alternate person who have authority to make medical decisions for you. That person has enormous responsibility. It is important then to have regular open and honest conversations about your final wishes with that person. He or she should have a copy of your living will and be ready to make decisions for you in support of that and the conversations you have had.A do not resuscitate order is one that only your physician can write while you are an inpatient in the hospital. It specifically limits by your choice what are called heroic measures in the event your heart stops or your lungs fail. Not specifically part of the DNR order, but equally important are those life sustaining measures that you might wish to receive or not. This may include intravenous fluids and artificial feedings, antibiotics and other life prolonging medications. A DNR order, signed by your physician may also be an important document to have at home or in a nursing home as it helps guide emergency personal who are responding to a life threatening emergency.Finally, a durable power of attorney is a legal document giving very specific powers to someone you name regarding medical decisions, sharing of health care information and signing legal documents on your behalf. It too is in effect only upon the presence of the two conditions I described in living wills.Finally, it is important to know that each of these end of life documents can be changed, modified or rescinded at any time. Think about your wishes in the event you suffer a terminal medical condition from which you are not expected to recover, and experience a decreased quality of life. Talk about it with those important to you as well as your physician. While living will and health care proxy forms are readily available, it is always a good idea to discuss these decisions and documents with your attorney too.I would like to invite you to join me for a talk “Your Wishes Honored, Thoughts, Plans and Preparations for the End of Life” at the Eagle County Public Library on Thursday at 6 p.m.Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily.


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