Remember that super awkward birds and the bees talk you had with your parents as a child? Chances are they’d known for some time you needed it and after it happened one or both of you was uncomfortable. As our loved ones move into their senior years, it is once again time to have one of those uncomfortable but necessary conversations – this time about end-of-life care.
Some of the questions to ask your loved one include; why do you need a living will, why are advance directives important and why do you need “do not resuscitate” orders (DNRs). Previously, we discussed the importance of discussing living wills and advance directives. Here we’ll not only review those differences (plus DNRs), but we’ll also discuss scenarios in which each could be applied.
What is a Living Will?
The purpose of a living will is for people to provide written instructions that convey their wishes for medical care should they not be in a position to express it themselves. It takes away from the stress of a medical situation by eliminating the strain on family members to figure out what their loved one would have wanted. To make a living will effective, you must have a conversation with your loved one and make sure the language is explained thoroughly. For example, “terminal” may mean different things to different people. In practical terms, when a medical situation arises, the wishes of the patient are adhered to by doctors — even if that means they take no life saving measures to prolong that person’s life.
What Does an Advance Directive Do?
The purpose of advance directives is to allow people more options for end of life care, even more than a living will alone. By naming a specific person as an agent of medical matters, decisions about care can still be made, even without being outlined prior. In the case of a medical emergency, a patient would entrust a specific person to make decisions on their behalf.
The Importance of DNRs
Do Not Resuscitate orders (DNRs) are put in place when both doctor and the patient have decided, commonly prior to a hospital stay, that because of the diminished quality of life there should not be any end of life measures taken for a patient. This is the main difference between a living will and DNR. Another important distinction to note is that DNR’s are different depending on if you are in the hospital or not. A hospital DNR may not necessarily be enforced in-home and vice versa.
Taking the Conversation Further
Living wills and advance directives are especially important for families to discuss, as unfortunately it is not uncommon for a medical professional to not adhere to them. This is not a result of malpractice, but a rather an outcome of the information being unavailable to doctors at the time of care.
It is also important to discuss DNRs, and to understand that they in no way mean no care is given, but rather certain extraordinary measures that would extend life are not performed.
To spur your conversation, physician Michael Barton makes a lighthearted parody of advance directives that includes some very helpful facts. Moving past the uncomfortable discussion can ultimately provide loved ones with the security of dying with dignity.