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Planning for the Unexpected

January 18, 2019

Often times when individuals execute advance directives, they have a preconceived notion of the aliment or incapacitating situation they might find themselves in, in the future. People also often execute these documents with the intent that they will not need to be used for quite some time.

 

 

One of the most popular advance directives is a health care directive. A health care directive allows an individual to appoint a designated health care agent to make decisions on their behalf if they are incapacitated or unable to make decisions on their own. It also allows the individual to indicate their particular wishes and desires regarding their health care.

 

One of the biggest decisions’ individuals face is whether to be resuscitated or intubated. These are usually referred to as a do not resuscitate (DNR) or a do not intubate (DNI). Many individuals feel very strongly one way or the other about DNRs and DNIs. There are many important factors that should be considered before selecting a DNR or DNI code status. These factors include:

 

  • Your goals for treatment

  • Your trajectory  

  • Your cultural/religious beliefs

  • Your families input

  • Your prognosis

 

However, in unexpected situations these factors may change for individuals. Pre-planning is different than current care planning. Every medical diagnosis has a different prognosis and that prognosis differs by individual. For example, if an 80-year old enters the ICU with respiratory problems and they are intubated, there is a much greater likelihood they will survive, and be able to return to their normal life than if they enter the ICU with heart failure and need to be resuscitated.

 

Individuals often indicate on their advance directives they do not want to be incubated or resuscitated if their condition is terminal or irreversible. It is very difficult for doctors to determine and to agree upon whether an individual is likely to recover or not.

 

It is impossible to predict the unknown, but it is important to consider these unexpected situations when planning and executing advance directives. When it comes to health care planning, and making these tough decisions there are ways to make the process easier for individuals, and to assure their wishes are followed. These include:

 

  • Discussing goals of care and code status with your doctor

  • Executing advance directives

  • Making sure the right people have access to and know about your advance directives

  • Choosing a health care agent you trust

  • Discussing goals, wishes, and desires about health care with family members

 

Having these discussions with family members can be hard but it makes the world of difference in emergency situations. When a person’s family knows their care goals and desires it makes it a lot easier for them to make decisions on their behalf, as well as assure they are being authenticate to their wishes.

 

Planning is important but end of life decision making is not always black and white. More often than not it is a gray area for both doctors and loved ones. Given how much uncertainty surrounds our health and what might happen to us, individuals should consider updating or drafting their advance directives to allow their health care agent to make decisions on their behalf based on the particular situation they are in.

 

You don’t have to make these decisions alone. Everyone needs a guide to help them through the end life and long-term care decision making process. Our attorneys are here to guide you through the process. Contact our office or book an appointment online to schedule an initial consultation.

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