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Many people have not talked with their loved ones about how they’d like to be cared for at the end of their lives. It’s an important talk to have, especially for those living with a chronic disease.
What kind of care would you want if you were no longer able to speak for yourself?
If you developed severe breathing problems, would you want to be placed on a ventilator, or a machine that breaths for you?
It's not easy to talk about end-of-life issues. Let your family know that by talking in advance, they'll be more comfortable if they have to make difficult decisions about your care.
The best time to plan for end-of-life care is while you’re relatively healthy. And a good person to start is with your health care provider.
Discuss the different kinds of supportive care you might want and for how long. Ask about the quality of life associated with different choices. Having this discuss with your health care provider can help you think more clearly about options you might want -- and not want -- at the end of life. In addition, to your health care provider, there are others who can also help:
Palliative care providers. These health care providers focus on lessening pain and other symptoms of long-term and serious conditions.
Hospice representatives. These health care providers offer end-of-life care.
Religious advisors or clergy members. Hospitals have pastoral counselors.
Social workers. Hospitals also employ these professionals.
Counselors or therapists.
There are also many resources available on the Internet.
People with advanced chronic pulmonary disease (COPD) need to consider the eventual need for palliative care. This is care aimed at making you comfortable as possible.
Palliative care is always part of end-of-life care. However, it can also be part of care for anyone at any stage of a serious or chronic illness.
The purpose of palliative care is to relieve symptoms associated with serious illnesses. Some of these symptoms may include pain, nausea, tiredness, anxiety, and depression.
Palliative care doesn't cure illness, but does attempt to make living with symptoms easier. Palliative care measures can help lessen shortness of breath, for example.
People with severe COPD, for example, generally benefit from finding ways to decrease their physical effort to take care of their daily needs. Examples include living on one floor of a house, or having meals provided.
Check with your health insurance plan to see whether this type of care is covered.
Put your wishes for end-of-life care in writing so medical staff and family members have a record of them. An advance directive is a legal document that guides your health care providers when you’re not able to make decisions for yourself.
A living will is one type of advance directive. This document describes the type of medical care you would like at the end of your life.
A medical, or durable, power of attorney is a second type of advanced directive. This document names the person you would like to make health care decisions for you if you are unable to communicate.
Your health care provider or local hospital will have forms for both types of advance directives. They are also available on the Internet. The forms vary by state, and it’s important to use forms accepted in your state.
Give copies of both documents to your health care provider and family members and keep copies for yourself. You’ll want them with you if you are hospitalized.
You may also want to talk to your doctor about the physician order for life-sustaining treatment (POLST). This form encourages active communication between you and your health care provider with the goal of preventing unwanted aggressive treatment at the end of life. The use of the POLST document and wallet card also varies by state. Talk with your health care provider about what is available in your state.
What you want may change over time. Make sure your documents are always up-to-date. If your wishes change, be sure to talk with your family and health care providers and update your documents.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.