When a proxy makes decisions that other parties, such as family members, disagree with, the authority of the proxy can be challenged. In order to address this issue, patients often draft a living will, which attempts to clarify the wishes of the patient.
Without legal guidance, the most frequent hierarchy is the spouse, then the adult children, and then the parents. 13 Physicians should encourage the decisions that best incorporate the patient's values, realizing that the most appropriate source for this information may not be the next of kin.
Before you begin the conversation about hospice or palliative care, several practical details should be carefully considered:
You can provide emotional support by listening and being present. Your physical presence — sitting quietly or holding hands — can be soothing and reassuring. You can also arrange visits with people the dying person wants to see for saying goodbyes or sharing memories.
You can if you are 18 years or older and are capable of making your own medical decisions. You do not need a lawyer. WHO CAN I NAME AS MY AGENT? You can choose an adult relative or any other person you trust to speak for you when medical decisions must be made.
Ideally, patients will have created a durable power of attorney for health care. If a patient did not do this, state statutes specify which individuals can serve as surrogates; a current spouse typically is the first choice. Ideally, surrogates should use substituted judgment in making decisions.
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When a person's body is ready and wanting to stop, but the person is still unresolved or unreconciled over some important issue or with some significant relationship, he or she may tend to linger in order to finish whatever needs finishing even though he or she may be uncomfortable or debilitated.
These issues include patients' decision-making capacity and right to refuse treatment; withholding and withdrawing life-sustaining treatment, including nutrition and hydration; "no code" decisions; medical futility; and assisted suicide.
Tips for Talking with Someone Who is Dying
Indeed, most doctors consider open communication about death vital, research shows. A 2018 telephone survey of physicians found that nearly all thought end-of-life discussions were important — but fewer than a third said they had been trained to have them.
Nurses are obliged to provide comprehensive and compassionate end-of-life care. This includes recognizing when death is near and conveying that information to families.
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