MAKING DECISIONS
It is important to plan for the future and empower ourselves with options that meet our needs and desires. When faced with a life-limiting or terminal illness, many decisions must be made. These decisions can involve financial matters, advance directives, funeral arrangements, how the last days of life will be spent, and other issues. Even though discussing these issues may bring up feelings regarding difficult losses and changes, it is important to be proactive and to communicate in order to ensure choice and control during difficult times.
A member of the Namaste Hospice team will assist its patient in facilitating a discussion with his/her family to plan for the future. The patient is asked to consider using the following guidelines to broach potentially difficult subjects.
- Plan ahead for the conversation.
- Be sensitive to the fact that you will be discussing emotionally laden topics.
- Choose a place and time that are conducive to an open conversation.
- Keep in mind that you may have to discuss the same topic on several separate occasions.
- Realize that family members may disagree and that the goal is to allow the patient to have a say in the matters being discussed.
- Use “I” statements to get your view and feelings across.
- Do not use this time to discuss old wounds or bring up unresolved issues from the past.
- Be aware that initial decisions may change.
- Collect brochures or articles for use during conversation.
- ADVANCE DIRECTIVES
- Namaste Hospice is committed to the wishes and dreams of its patients and families. Therefore, we are happy to help them establish instructions and legally-binding documents to ensure that their desires are fulfilled.
Directive to Physicians (Living Will)
A Living Will is a document signed by a patient that states to physicians a patient’s wishes for how he or she wants to be treated in certain medical scenarios. This is one of the best ways to assure that decisions are clarified and respected. Copies of the patient’s Living Will should be given to his/her physician, family members, and the Namaste Hospice team. A Living Will may be revoked or changed at any time. The Five Wishes booklet provides an easy-to-follow Living Will that is legally binding in Colorado, as well as several other states. Namaste Hospice will provide patients with a copy of Five Wishes to complete, if requested by the patient or family.
Medical Durable Power of Attorney (MDPOA)
A MDPOA document gives the person the patient names as his/her agent the authority to make any and all health care decisions for him/her, in accordance with his/her wishes, if he/she is no longer capable of making them him/herself. A MDPOA can cover more health care decisions than a Living Will. A MDPOA may be revoked or the agent may change it at any time. It becomes effective only when the patient becomes incapacitated and is unable to make his/her own decisions. Again, it is important to ensure that your physician, family and Namaste Hospice team has a copy of your MDPOA.
Power of Attorney (POA)
A POA gives the person the patient names as his/her agent the authority to make decisions that are not of a medical nature. These decisions could regard finances, real estate, etc. A POA may be revoked or the agent may change it at any time. It becomes effective only if the patient is unable to make his/her own decisions.
Do Not Resuscitate order (DNR)
Cardio Pulmonary Resuscitation (CPR) is an emergency procedure consisting of artificial respiration and manual chest compressions performed in an attempt to revive a patient whose heart has stopped or who has stopped breathing. A Do Not Resuscitate order (DNR) is meant to prevent CPR from being performed if that is the patient’s wish. A DNR may be revoked at any time. Signing a DNR will not prevent the patient from receiving other kinds of needed medical care such as treatment for pain, broken bones, etc.
FUNERAL PLANNING
Rituals are an important form of communication and can facilitate the healing process. Rituals have been used since the beginning of time to celebrate major life changes such as birth, marriage and death. Mortuary personnel or clergy will provide a number of valuable services during this time to assist you in celebrating the life of your loved one. Namaste Hospice can direct the patient to the right resources and help plan a memorial service.
Funeral services serve a number of important functions:
- Honors a loved one
- Provides a socially acceptable place to express grief and mourning
- Provides closure to the person’s life
- Provides social and psychological support to survivors
It is recommended that patients and/or family members check with local funeral homes to gather information about what options are available for preplanning. Before talking to the funeral home, the following questions should be considered by the patient and/or family members. (Typically, the Social Worker is responsible for initiating this area of discussion.)
- Does the patient want a funeral, memorial service, cremation, or a combination?
- Is the patient interested in donating organs or tissue for medical research or transplantation?
- Which funeral home does the patient want?
- Is there anyone the patient would like to preside over the ceremony?
- What songs would the patient like to have played?
- What clothing or jewelry would the patient like to be wearing?
- Would the patient prefer to have people send memorial gifts to a charity in lieu of flowers?
- Where would the patient like to be buried?
- How would the patient like his/her cremated body cared for?
Research options for pre-paying and compare costs if possible — Namaste Hospice can help through this process. Find out exactly what each cost will cover, and get it in writing. Any amount of preplanning that can be done will be very helpful for family members and friends.
Death comes to us all and most of us will experience numerous deaths of loved ones. Each one will affect us in different ways. After the patient’s death, be sure to express your needs with the Namaste Team and your family and friends. Find some alone time to reflect if you need to. This will be a period when you start the grieving process, which is necessary in healing. The Namaste Hospice team will be there to assist during this process.
