End of life choices

(This is taken from the book Positive Options For Living With Copd, by Teri Allen)

No one likes to think about dying, but the reality is we are all going to do it whether we are ready or not. By preparing beforehand, you can make choices about your medical care before an emergency occurs that will affect your quality of life as well as the dying process itself.

Talk with your family
Make sure your family knows your wishes in the event of an emergency. Discuss which medical treatment you do or do not want. Remember that your family will be speaking for you when you cannot. Let them know your wishes regarding:

Intubation and mechanical ventilation: Do you want it? For how long?

Resuscitation: If your heart stops, do you want chest compressions and medications delivered in a attempt to restart your heart? Chest compressions can be brutal for the elderly and those with COPD because the bones of your ribs and chest may be broken in the process.

Tube Feeding: Do you want a tube placed in your stomach to feed your body in the event that you cannot eat? Do you want one temporarily or permanently?

Comfort Care: Would you rather not be aggressively resuscitated but be made comfortable in your final days or hours?

Advanced Directives
An advanced directive is a written record outlining your desires in the event of a life-threatening emergency. It should be completed and kept on file with your doctor and the hospital you use. This is especially important if you have no close family or friends. You may also appoint a power of attorney to enforce your wishes.

Physician Orders for Life-Saving Treatment (POLST)
This is a simpler form of the advance directive designed to let your desires be known to the 911 medical personnel who respond to a call from your home. The POLST form is typically posted in a visible place such as on your refrigerator and is the only way for emergency personnel to know your advance directives. Emergency personnel are required to perform resuscitation, including intubation and chest compressions, unless the form is present or your family is available to let your wishes be known. This form is for emergency personnel only and does not replace the advance directive used by the hospital.