Question

What resources might you be able to offer a dying patient?

Answer 1

Resources to offer to dying patient-

• Advance directive / living will
• Medical power of attorney / healthcare proxy
• POLST/MOLST
• Advance care planning with Alzheimer’s/dementia

You can also acquaint yourself with the following services:

• Palliative care
• Hospice

Advance Directive / Living Will

An advance directive, also known as a living will, allows you to document your wishes concerning medical treatments at the end of your life. However, emergency medical technicians cannot honor your advance directive. The only document they honor is the Do Not Resuscitate (DNR) order.

Medical Power of Attorney / Healthcare Proxy

A medical power of attorney, or healthcare proxy, allows you to appoint a person you trust as your healthcare agent (surrogate decision maker). Your healthcare proxy is authorized to make medical decisions on your behalf, but only if you are unable to make your own medical decisions. It is essential that you explain your wishes to this person because, studies have shown, people think their loved ones know what they want. This is false. When questioned, friends or family often incorrectly assume what your wishes are regarding end-of-life options.

It is equally important to confirm that your health care proxy is willing to follow your wishes, even if they disagree with them.

POLST (Physician’s Orders for Life-Sustaining Treatment) / MOLST (Medical Orders for Life-Sustaining Treatment)

POLST or MOLST documents your healthcare wishes in your medical chart. Benefits of participating in a POLST program include:

• medical professionals’ ease of access to your care documents;
• increased likelihood your healthcare wishes will be honored during an emergency;
• portability (POLST/MOLST forms can follow you from institution to institution).

Advance Care Planning for Alzheimer’s Disease or Dementia

While Alzheimer’s and other dementias are daunting diseases to face, advance planning may help provide a small amount of control.

Palliative Care

Together with hospice (see below), palliative care is central to end-of-life care.

Palliative care refers to the treatment of the symptoms and stress of serious illness, with the dual goals of comfort and improved quality of life. It provides relief from distressing symptoms including pain, shortness of breath, nausea, insomnia, and side effects of medications. Although people often confuse the terms hospice and palliative care, in the latter you can receive curative medical treatments. People usually receive palliative care at clinics or hospitals, but home care may be possible.

Hospice

Hospice seeks to optimize the quality of life in the terminally ill, while neither hindering nor hastening the dying process. Hospice is not a place but rather a type of care that enables a peaceful death. It is covered by Medicare, Medicaid, HMOs, the Veterans Administration, and most private health insurers.