As I watch my mother (88 years) in ICU, I wonder at the emotional roller coaster and decisions that the doctors are asking my father to make day by day about "next steps". When we have conversations with them, they always act like there is a path to recovery, but it doesn't look like that to me. One day is better than the next and those are the days they ask if we should take the next surgical step to keep her alive. I never want to put my caretakers in the position of wondering what to do - I want to write detailed instructions as to when they should let me go. With the doctors always suggesting the next "hope", how can I predict what condition allows my loved ones to say enough? How can I write up thought provoking questions so that they make the right decision to allow me to go so they can live their lives?
Near the end of my Mom's life I sought cousel from a cousin who had worked in a CCU. Naturally, she couldn't tell me what to do but she did describe how some families find it so difficult to let go and how she saw older fragile patients be resusitated over and over. One 90+ person was resusitated 5 times in 4 hours before she passed. This helped me to retain my Mom's DNR!!!
But realize that however thorough you try to be, no one can anticipate all circumstances. That is why it is important to have as your healthcare POA someone who knows you well and knows your general attitudes, if at all possible.
I knew that my husband didn't want his life extended artificially, and he had a DNR in place. But what about the time he had stomach pain and blood in his stool? I stayed with him and comforted him and then asked him, should I call 911? And he wanted that. But what if had not been conscious? What if I had to make that decision on my own? Yikes! The paramedics took him to the hospital where he was treated for a bleeding ulcer and he lived another 8 years, most of them with a fair quality of life.
Do your best to be comprehensive, but realize there may be judgment calls regardless.
I had an Elder Law Attorney draw up a Living Will and Advance Medical Directive [same as what Pam had mentioned above]. My Attorney also did a "Memorial Instructions" for who, what, where, and when when I finished my last chapter.
One thing I need to check with my Attorney regarding my Living Will is CPR. I would want CPR unless I am already in a terminal condition and it is time to let me go.
I had put together a large 3-ring binder for my parents to fill out regarding legal papers, elder care, wills, final plans, etc. Of course, when my parents had passed, not one question had been answered... [sigh]. Here were some my questions:
If you can no longer be independent in your own home, what do you wish to do? Would you prefer to live at home to hire a professional certified trained caregivers to help during the day/around the clock? Do you wish to hire cleaning people?
Or do you wish to move to a retirement community where you will get full-time trained professional care, quick medical help, and be around people of your generation and to enjoy what is offered by the facility?
Do you have long-term health care insurance? If so, name, account #, address and telephone number.
The list goes on and on.