October 2, 2014
Having Your End of Life Wishes Followed
When a doctor or nurse asks you who is your emergency contact, do you know whom they are asking about or are they asking for an advance directive? Don't know do you? Even they are unsure, but they will make a mistake either way. Doctors, nurses, hospitals, even other health care providers ignore what is in their files, computers, and even what seems like common sense.
If a family member is present, that will be the person they listen to and they will not look at their medical files on you to see who is responsible. The family member may not be the person trusted by you and the one to carry out your wishes. Most often if the person present will agree with the proposals of the doctor (often the most expensive) this will be the course of action. They will not pay attention to “do not resuscitate” (DNR) orders or other orders that may be on file. This applies to doctors, hospitals, and especially nursing homes or long-term care facilities.
Hospitals and nursing homes want to keep the beds full and if they are and know they have people waiting for admission, they might obey DNR orders. Financial decisions are the rules applied and they are very difficult to override. Even when the person the patient has chosen to be their decision maker is available, they will often contact other family members first hoping to bypass the advance directive or the emergency contact person. Money rules and is the driving force behind the decisions made.
I am in a real quandary as my adult children have stated they will not follow my wishes and my wife will not talk about death. I have finally asked two friends if they would serve in that capacity. Both have agreed and I have arrived at a plan that may serve my wishes. The doctors are not happy with my plan and have asked for the names of my family so that they may be contacted. I have carefully not given them out and only given out the names of my two friends. It is unfortunate that my wife works for the local hospital and will possibly have influence in the final decisions. This is because Medicare requires the ambulance to take me to the local hospital first and then I can be transferred, if needed and approved, to another hospital.
The purpose of this blog is to encourage people to talk about death with their family and make sure everyone agrees with your wishes. This is often not an easy task for everyone as many family members just are not ready to talk about the future. It is better to do this while you are at your full faculties and your decisions cannot be disputed, or are less likely to be contested.