My point is simply that they (the “play god, gasp!” religious wackos) are very selective about which voluntary actions enabled by human agency they consider to be enacting gods’s will and which equally voluntary actions they consider to be thwarting god’s will.
It’s nonsense all the way down.
Also: with a medical power of attorney, you are giving someone else the right to make decisions in case you are not able. You can specify preferences, but as far as I know, those preferences are NOT legally binding. If you say “no interventions in case of x, y or z”, Junior could decide that he wants you to have that intervention anyway.
A DNR is (I think) somewhat different: if I understand it, hospitals and EMTs can NOT perform actions to resuscitate you, or place you on ventilators or whatever. I don’t believe they can remove you, if you are already on a ventilator when they get the DNR, and I don’t know how it works if, say, you’re on a vent after surgery and it’s decided that you are unlikely to regain functioning.
It’s also a good idea to make sure family dynamics won’t be a huge issue. As @puzzlegal found, siblings can argue. When my mother was in the hospital the last time, there were still hopes that she could go home. She wanted to refuse things like another bronchoscopy (palliative care, I gather: she had lung cancer). Brothers 1 and 3 had her power of attorney and were prepared to honor her wishes. Brother 2 basically had a tantrum about everything and threatened to take 1 and 3 to court to have them overturned so he could FORCE Mom to have such a procedure. Not sure how that would have played out, if she was mentally capable of saying no; years before that, he’d tried to enlist us all in having Mom involuntarily committed to force her to quit smoking, so he might have argued the “she’s clearly not capable of looking after her best interests” card.
As it turned out, Mom declined fast enough that the issue never arose (and B2 actually went back home before she even passed away - had to look after his dog or some such). He later tried to recruit ME in an argument about certain aspects of the estate - which would have been laughable if it hadn’t been so stressful. Needless to say, his attempts were unsuccessful on all counts. Yeah, jackass, abuse me and the entire family for 50+ years and you will indeed wind up alone and estranged from every relative you have.
I once worked part time in a nursing home that had varying care levels. I worked in the kitchen that served folks who lived in their own little apartments but dined together. Sometimes I had to go down to special care units and it was so sad to see folks who needed help holding their utensils. I hope never to be like that but am concerned because I’ve begun to develop tremors in my left hand.
One time a little old lady was wheeling herself past me and stopped to tug at my sleeve. I think she thought I was a relative, and told me she had heard that my brothers and I were fighting and she wanted peace in the family. So I pretended to be whoever she thought I was, hung my head and told her I’d been feeling bad about that and I would see what I could do. She wheeled away happy. Was that wrong?
That is so sad. I am so greatful that my family is tight knit and cares about each other. In fact, one cousin of mine, who is a nurse-practitioner, has my medical POA, ahead of my sister, because she knows medicine and is not in the least sentimental. Sis is next, as she does know medications, being a pharmicist.
How does one get a dnr or living will?
You can have a DNR prepared yourself, actually. You might not WANT to at this point, depending on how your health is - e.g. if you fall ill and it’s something that is recoverable, CPR or a ventilator might give you more quality time.
My in-laws each had them in place. In their state, the form had to be on a specific color of paper to be legally binding - which I gather required them to have it prepared a second time (by their doctor, I think). The forms lived on their fridge, which was a recommended location in case they had to call the paramedics. IIRC, my sister-in-law may have signed a separate form when FIL was in the hospital, as she had his power of attorney (when the ambulance arrived, resuscitation was not an issue).
You can do the living will yourself. Lots of fillable forms available online. You’ll need to get 2 witnesses to sign, if I remember correctly, and a form done for one state is valid in all the others. Here’s one central link:
That’s how my husband and I did ours, and we had both kids do them as well so we could step up in case of emergency. As a side note: any of you with adult kids, especially those who are young adults without spouses etc, STRONGLY encourage them to prepare such a document. When my depressed nephew made his first suicide attempt as an “adult” (he was 18), the doctors couldn’t discuss it with the parents at all, until he was finally convinced to sign one. I made my son do one before he went to college, and my daughter before she went to her residential treatment facility. In both cases, I assured him that we would never invoke this unless they were completely incapacitated or we genuinely feared for their safety. Luckily this has never arisen.
I’m not as sure about the DNR. I think my in-laws had their doctor prepare one to keep at home (I know I saw MIL’s still on the fridge, when we went down to clear out their condo). I don’t know if those can be self-prepared the way the living wills can.
Boy, that is such a sensible way to frame the issue.
DNR/living will can vary by state, so make sure you pull up the correct version. Much of the language is codified by statute - which is usually referred to in the form, so you can feel comfortable just executing the form. Then make your wishes known and give copies to your doctor, your family, etc.
Wow. That is… spot on!!!
I think in some part, B2 was terrified at losing his only remaining parent. He’s never had a successful long-term relationship, and Mom was his anchor. Despite his having been verbally abusive to her as well at times, and cutting off communication for a few years, she never gave up on him - and in a final note to the rest of us, she implored us to keep him in our lives as he was so lonely.
Yeah… no. That ship had sailed. He swam after it, torpedoed it from underwater, sent a rescue boat to pick us up, and then torpedoed that one.
W/ my MIL, once she was in hospice, in obvious pain, bedridden, and incapable of recognizing her daughters, wife’s sister (who insisted MIL change her to PoA/executor from my wife) refused to allow pain meds because they might “hasten her death.”
Somehow she did not view that as torture…
Yikes!!
Make sure that wife’s sister person has no role in your or your family’s end-of-life care.
If folks are interested in collecting all their info in one place, including various powers of attorney, the following is the book for you. There are other similar works out there as well. I bought it and my sis, who is the executor of my will, appreciates it because this book, in a file cabinet along with some other docs, and my safe deposit box, ensures it will be much easier for her if I unexpectedly get in the handbasket.
Oh, true.
I think the particular (fairly young, which may be relevant) person I was talking with had simply never heard a serious objection, though, and looked like he might actually be paying some attention to that one. I lost touch with him, and have no idea what his opinions are now.
I don’t think it was wrong. If she could no longer tell people apart, she probably soon forgot the incident; and it made her feel better for a while. Even if she remembered it – it still made her feel better for a while. And if she did remember it, it’s not like you made any full scale promises on behalf of the relative.
My mother additionally carried a copy with her whenever she went out. I think New York State allows for multiple copies; I can’t remember for sure that she didn’t take the one off the fridge, but I’m pretty sure that one lived permanently in her purse.
However, I was told, during her last few years, that if she collapsed entirely, I should call her doctor first, NOT the ambulance/EMT’s; because the EMT’s were likely to be trained to resuscitate no matter what.
When she fell and hurt her leg, though (in her apartment an hour’s drive away from me), she did call the ambulance; though she refused to go with them until I promised I was on my way and would find her at the hospital, as she was afraid of having the hospital insist on something she didn’t want to have done. And I would also of course have called 911 if something had happened while she was here, but it seemed plausible that it was something she’d recover from.
Everybody old enough to legally do one should have a health care proxy filled out. Anyone can get hit by a truck.
A person who’s conscious and competent can revoke it or override it at any time.
– I also think a DNR is a different thing altogether, and may have to be signed by a doctor. And, at least a couple of decades ago in NYState, there are two types: a non-hospital DNR that you can carry with you, and one specific to a hospital or other facility that you’re admitted into. When my mother was admitted for her broken hip, I as her proxy had to sign the facility’s DNR form for her; the one in her purse, AIUI, only counted outside their doors.
During my mother’s last couple of years, I at first felt somewhat grumbly about other relatives who made lots of encouraging noises from a distance, but provided little practical help.
Then it occured to me: it could be worse. They could be making discouraging noises from a distance.
Then it occured to me: it could be a lot worse. They could be making discouraging noises from up close.
After that, I felt a lot better about the encouraging noises from a distance.
I had that argument, very briefly, with a nurse while my mother was dying. My mother was no longer able to speak, but she was able to clearly indicate that she was uncomfortable; she was being prescribed a bit of morphine, so I asked for her to have the next dose.
The nurse said it was too soon because it would depress breathing and might hasten her death.
There was absolutely no question but that she was dying, and within the next couple of days. I got insistent and they got the doctor and the doctor overrode the nurse, saying to me that I shouldn’t have had to deal with that.
I was even more furious at the home nurses helping take care of a friends’ mother. The mother, who again was unquestionably terminal although with less precision available as to when, died on the second day of a family gathering at the house she was staying in, and also had morphine prescribed, in this case as oral medication. She’d asked my friend to give her a dose at a usual time for it, and my friend of course complied; the mother went to sleep, and died in her sleep later that night. The – insert adjective here, I can’t think of one nasty enough – nurses told my friend that it was her fault that her mother had died, because she’d given the requested morphine. Not that that was why her mother had died that night instead of maybe the next – that it was her fault that her mother had died at all. The nurses were refusing to believe the terminal-very-soon diagnosis.
Now that is wisdom.
Egad!!!
One hopes that in both cases, the nurses were reported to supervisory boards of some sort. The concept of “adequate pain relief, even if it hastens death” is pretty widely known and accepted… except among morons.
My mother was put on morphine her last day or so in the hospital; she’d basically lost consciousness already and everyone knew it was coming - and she actually was not in pain, as far as we knew. But as the doctor explained it, she was struggling to breathe, and the morphine reduced the air hunger some, thus making her more comfortable.
I don’t know, or don’t remember, what my friend did – besides ask me anxiously whether I thought the nurses were right. (Yes, we talk about these things! I think she was reassured by my fury.) I effectively reported the nurse in our case to the doctor, who disagreed with the nurse vehemently enough that I expect the doctor did whatever they felt they could with procedures available at the time.
Rather to my surprise, when my mom was dying of covid, her blood oxygen levels actually increased a little after the nurse was able to stabilize her pain with morphine. I mean, my mom died soon after, but that was going to happen anyway. I had expected the morphine to hasten death a little, and as best as i could tell, it absolutely didn’t.
The home hospice nurse was super, and she worked with my mother’s aide who volunteered to stay up all night, gradually increasing the dose of morphine until my mom stopped exhibiting signs of pain. She’d give her some, wait to see if it worked, and then call the doctor for permission to give more. But she just kept ramping up until it worked.
Assisted suicide is illegal in my state, and the nurse told me that she often had to tell clients she wouldn’t do that. She said it wasn’t just because if the law, but also due to her personal beliefs. But she was not stingy about mitigating pain.
(FedEx, to on the other hand… It took us a day longer than it should have to get the morphine, because FedEx promised it and then dropped the ball. They finally admitted it wasn’t coming that day at 4 in the afternoon [having been promised late the prior day] and the hospice doctor, my mom’s pcp, the nurse, me and my bil collectively found the drugs at one of the few local pharmacies that stocks morphine. What a nightmare.)
Also, i want to emphasize that none of the sibs was awful. My brothers just weren’t ready to let go. And my sister had been my mom’s first choice for healthcare proxy, and declined, because she was afraid she wouldn’t be able to pull the plug. She has regrets about keeping a couple of pets alive too long, and didn’t want to do that to her mom. She was great, and backed me when i insisted it was time to call in hospice.
My mom died first, very unexpectedly after being sick for just a few days with the flu that invited drug resistant pneumonia along. One of my regrets now is that we, mostly me but also my brother to a lesser degree, encouraged Dad to go to the e.r. the day after she died because he also was very ill (I was pretty sick too but just got tamaflu and cough medicine with codine) and the urgent care thought his condition was serious. We didn’t know then that this would be one of many times Dad would spend a week or so in the hospital over the next 3 years until he finally got doctors to agree to place him on hospice.
Three and a half very long years of late stage COPD that caused him so much pain before he finally died a week before he’d have to be recertified for 6 more months of hospice. Maybe it would have been kinder to not insist he be treated that first time. He thought that suicide would led to going to hell and therefore just waited for death to finally arrive, so I worry that we did him no favors by wanting him to be seen back then…
Dealing with a parent’s declining health is often one of those damned if you do, damned if you don’t situations, guilt is in the cards either way unfortunately.
This is just me.
I’m in a state of dying. (Well, we all are really) I think I’ll be there sooner than many of you guys due to my overwhelming health conditions.
In the last 3 years things have really gone down hill. I’m on a good turn, at the moment but I have yet another unexpected surgery Friday.
And I’m scared.
I’ve told my family my wishes. I expect they’ll honor them.
It’s horrible being at the mercy of who’s caring for you. My CNA is a good woman and very good at her job. (Very expensive, as well) but she’s a human with all their foibles. I know I can’t do all I need for myself but, dang it I keep thinking I should be able to.
With her and my family I’m getting what I need now.
I dread the thought of next year and what it’ll bring. I have no plans made to do anything to myself. Like others I don’t wanna make a mess that would distress anyone. I could do the medication easily but it scares me. What if you got halfway done and just passed out? That would be a terrible way to wake up.
So I don’t go down that path too often.
In the last few months I’ve had some confusion and over sleepiness that is concerning. So I’m surely gonna be mentally incapable soonish to make any decisions.
I don’t know what to do.