So, do you have a Living Will?

SweetPear · Post by **SweetPear** » Sat Apr 02, 2005 12:51 am

I had started to compose one at one time but never finished it. I have now! I think it's pretty important......what do you think? Do you care? Think it's important?

Otis Westinghouse · Post by **Otis Westinghouse** » Sat Apr 02, 2005 3:52 am

Is 'Living Will' the standard term in the US, as opposed to just Will? I've never made one. Bit stoopid for a guy with three kids, maybe it's a fear of one's own mortality. Now I'm finally a grown-up (almost), I should do one.

Goody2Shoes · Post by **Goody2Shoes** » Sat Apr 02, 2005 12:03 pm

Otis, you have been obviously and mercifully spared the Terri Schiavo Circus Deathwatch, or you would know what a Living Will is.

A living will is a document that specifies what end-of-life measures you wish to undergo (or wish to avoid) if you are incapacitated and cannot speak for yourself. It protects your interests, and relieves your family of the burden of having to guess what you would have wanted.

I have both kinds of wills.

RedShoes · Post by **RedShoes** » Sat Apr 02, 2005 12:19 pm

I don't, yet - but I've seriously been considering it. It doesn't seem like such a strange thing to do in your 20's anymore.

Terry was only a few years older than I am now when she had her medical problems. I'm pretty lucky though, as all of my family is in agreement with how those sorts of situations should be handled. Though, of course, having a loved one in that sort of situation can change ideas pretty quickly I'm sure - so having it in writing is likely the best plan.

Post by **DrSpooky** » Sat Apr 02, 2005 12:25 pm

What goes on in other countries in these matters? Is the living will unique to the US? I recall one report mentioning that the UK had legal standards to follow in these cases. Could some of the board members from other parts of the world share how it is handled in their country?

I don't remember if my father had a living will or not but he had made his wishes extremely clear to everyone so there wasn't much family discussion over how he wanted to spend his last days. We were all sure he did not want to be kept alive artificially.

Otis Westinghouse · Post by **Otis Westinghouse** » Sat Apr 02, 2005 7:02 pm

I see! No, I haven't been following that case at all. I think I follow the news less as I get older. Too busy reverting to my teenage mentality and listening to music.

As far as I know, the concept doesn't exist here. Voluntary euthanasia of any sort is outlawed in the UK. There's been controversy over Brits going to Switzerland to be put to sleep. You have to keep on in there till the machines can't do any more.

so lacklustre · Post by **so lacklustre** » Sun Apr 03, 2005 3:26 am

There are comparisons over here. There was a recent case to do with a baby, where the hospital had revived the baby on x number of occasions after some sort of failure and were arguing that the to do so further would be putting the baby through unnecessary suffering. They weren't going to withhold treatment to make the baby comfortable etc. and they certainly weren't going to starve the poor thing to death. I think the parents disagreed and went to court. Can't remember the outcome but I think the baby died anyway. Very sad but these things happen. Maybe I should start an RIP thread.

miss buenos aires · Post by **miss buenos aires** » Mon Apr 04, 2005 1:43 pm

RedShoes wrote:I don't, yet - but I've seriously been considering it. It doesn't seem like such a strange thing to do in your 20's anymore.

Terry was only a few years older than I am now when she had her medical problems.

That is true, but wasn't her heart attack related to a potassium imbalance in her blood that may have been bulimia-related? I mean, we could still have horrible health problems, but maybe it wasn't as out of the blue as all that.

RedShoes · Post by **RedShoes** » Mon Apr 04, 2005 2:03 pm

Yeah - it's not like she was perfectly healthy beforehand. But it's still scary. For me at least.

selfmademug · Post by **selfmademug** » Mon Apr 04, 2005 2:12 pm

I'm far from expert at these things, but my general understanding is, once you're plugged into any sort of automatic breathing/feeding systems because you lack the consciousness to do it yourself, it's a legal mess to get unplugged. However, one has choices about whether or not one ever wants to be plugged into such machines in the first place, and under what circumstances, and that's the sort of thing (among others) that can be specified in a so-called living will.

I took a writing class maybe ten years ago with writer/doctor Abraham Verghese (fantastic guy and writer, I highly recommend reading his stuff) and said he was thinking, seriously, about getting a tattoo on his chest that read DNR, standard med code for Do Not Resuscitate.

RedShoes · Post by **RedShoes** » Mon Apr 04, 2005 2:22 pm

selfmademug wrote:he was thinking, seriously, about getting a tattoo on his chest that read DNR, standard med code for Do Not Resuscitate.

I can't help but wonder if a tattoo would work as a legal request

Goody2Shoes · Post by **Goody2Shoes** » Mon Apr 04, 2005 2:30 pm

In my experience, it's much less messy to unplug a ventilator than it is to remove a feeding tube. It's easy to view artificial breathing as an extreme measure.

Not so much, though, in the case of a feeding tube. I think it's probably easier to refuse a feeding tube in the first place than it is to remove one later on, or stop feeding at a later date. Once the tube is in, a whole Pandora's box of possible scenarios is unleashed. I think that this might be because food is so "emotional", while breathing is merely functional.

A DNR tattoo - now that would be a legal mess!

selfmademug · Post by **selfmademug** » Mon Apr 04, 2005 2:36 pm

I think Dr. V's idea was that he didn't want anyone jabbing a tube in him without first checking his paperwork (living will) something that happens all the time, and that the tattoo might prevent that. I mean, in this day and age, doctors have to write NO on body parts of surgery patients as a no-brainer way of making sure the wrong limb, etc., isn't operated on!!

Anyway, I also happen to know he had a fascination with tattoos...

Post by **spooky girlfriend** » Mon Apr 04, 2005 2:40 pm

You too, Mug? The last time they operated on my wrist I actually did go into surgery with YES and NO stickers on each of my arms.

Mr. Average · Post by **Mr. Average** » Mon Apr 04, 2005 3:00 pm

We can write about this topic all day and night for the next year and at the moment of truth all bets are off. Off. This issue is about a grey as they come. There is no black and white world in which to entertain this topic.

My father dropped a few years back completely unexpectedly. His heart stopped for many minutes (more than 5) and he suffered an event called a "cerebral anoxic insult", which translates to no oxygenated blood to the brain for some period of time. The brain is intolerant to anoxia after about three minutes, but that number is subject specific...there is anecdotal and epidemiologic data but every person has the potential to be an outlyer- to not 'follow the trend". Most of the people on this board, socially, are outlyers.

Anyway, to the crux of the matter. My father had penned a living will about a decade before which was filled with legal jargon but essential said that if he was not able to be resucitated that food and water should be withheld until death. According to the Living Will, that was his wish. Even though my father was a brilliant scientist and an engineer (in the roped off section of heaven, BWAP) he had no idea what the dynamics were associated with the transition from life to death...and possibly, back to life...a reasonable life where love and happiness can indeed be felt and celebrated.

So we had a family meeting and tried as hard as possible to pin down the doctors as to the real prognosis: half said that he was PVS (persistent vegatative state) and the others said that with time there could be some reasonable amount of rehab, but he would never be the same guy. Could he ambulate again someday on his own? Unsure. Would he be able to utter a word? Unsure. Would he be able to enjoy and know his grandchildren? Unsure. etc etc etc etc ect. There is no end to the way the mind of a loved one works in this situation...no matter how much pre-planning is done.

So the family was split, and discord prevailed. Until...until Father Paul came to institute the Sacrament of the Sick (formerly, the Last Rites). To that point, Dad had not made a sound, only the sound of his mechanized, perfectly synchronized breathing, all paced by brainstem/lower more primal centers of the Central Nervous System. As Father Paul started to pray the "Lord's Prayer" my father became agitated, vocalized, and moved his head from left to right. His auditory cortex was intact enough to understand these things:
1. It was Father Paul speaking, and;
2. He was administering the Last Rites, and;
3. He was saying the Lord's Prayer and dad was reacting to it. By moving his head (the absolute first motor activity since he fell) he was implying "No"...that he wasn't ready.)

So I brought Father Paul back after 48 more hours of waiting for a decision, for my father to pass from life to death...but this time I assembled the entire family. Again, on schedule, Dad reacted when Father Paul came into the room, and tried to pray along, but his speech motor cortex was too damaged. It was clear to the fam that he could hear and understand, but he could not adequately speak or move to express his feelings, his thoughts. He was in a very cruel sort of prison for a brilliant scientist, but one thing was certain to the entire family, and that was clearly that he was not yet ready to die, and that whatever was penned in his living will was moot. He had personal, unfinished business, and until we figured out what that was, and we were able to communictae it to him, he was not ready to let go.

We continued food and hydration, and he did a little better, showing some increased (albeit subtle) signs of consciousness. Then on the 8th day, after the doc's prepared us for what could be 8 weeks, 8 months, 8 years, or more of the same, I received the information that he was seeking...the information that he needed to be at peace and let go. That information was in the form of a financial statement that I prepared that proved that my mother, his wife of 42 years, would be financilaly solvent, and that she would suffer no major financial distress as the result of his passing away. My mothers well-being was always the number one thing for my Dad. Always. We should have figured it out sooner!
I gathered all of the insurance claims data, verified them, all his VA death benefit info, savings accounts, and a plan to pay off the mortgage in full on the house if and when he passed.

I delivered the statement to him line by line in the presence of my sister, an RN. He reacted with an grunt to each statement, and within 1 minute of my invitation to let it go, he changed his breathing, and became apneic. He stopped breathing entirely after 19 minutes. His blood pressure dropped wildly within the first 4 minutes.

He was at Peace at home. He was at Peace with God. And all together, a decison was made with my father at the switch, to let it go.

The Living Will would have precluded my Fathers ability to make the peace he had to make before transitioning. He understood that only after he lost his ability to speak. But he mustered all of his energies and spirit to communicate to us in a way that he KNEW we would understand. He made the decision together with the One Master of Life and Death.

If you pay an attorney or Staples for the paperwork, and think you have a robust living will, you are wrong. Unless you really sit down with all of your loved ones, and openly discuss it, it won't be worth the paper it is written on.

Even then...you never really know how you will react to a situation until you are in it (much less a life or death situation). Atheists suddenly pray. Agnostics find the answer. And 'brain-dead' people find ways to communicate on a different level. Brain-dead. Beware that clinical term, because it means NOTHING. Take five minutes before you sign your living will and speak to a real medical neuroscientist, and they will tell you that we know precisiely 'dick' about the deep workings of the brain. Precisely dick.

Go with that.

tallulah · Post by **tallulah** » Mon Apr 04, 2005 8:23 pm

A Living Will specifies what measures you want to be taken to keep you alive and generally asks specific questions like "what if you can't talk but you have the ability to see and touch and taste?" etc. Durable Power
of Attorney is something you should also have - giving power to someone else to speak for you. This is really what would have prevented a lot of the Teri Schiavo drama - if she had made it clear her husband was her voice.

SweetPear · Post by **SweetPear** » Mon Apr 04, 2005 11:45 pm

spooky girlfriend wrote:You too, Mug? The last time they operated on my wrist I actually did go into surgery with YES and NO stickers on each of my arms.

Hey Spooky, I can beat that.....I actually had YES on one boob and NO on the other one in black marker before my surgery!

SweetPear · Post by **SweetPear** » Tue Apr 05, 2005 12:05 am

Oh Mr. A......you've got me all stirred up again. I actually have a Durable Power of Attorney for Healthcare and then I've written out some stuff in my own words. I have talked to my family many times about it and we all disagree and you're right.....there's no absolutes. There's no way anyone could ever predict how they'll react.
I've written some general things down but also specifically said that it's impossible to predict the future and that I hope my family will discuss my situation, taking my wishes into consideration, and then make as best a decision as possible. I think I left more directions as to what I want after I'm actually dead than anything else!
No, it's not a sure thing and it doesn't make me feel completely at ease, but it's something.
(Anyway...my husband's such a fucker, he won't listen to a word I wrote.)
J/k.....but he's having a grand time yanking my chain. He's just simply said he wants to be kept alive at all costs and by any means possible.
(He's making fun of me.)