How to Navigate End-of-Life Care Decisions When Family Members Disagree

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Wilfred Poole
How to Navigate End-of-Life Care Decisions When Family Members Disagree
  1. What will happen if a patient's family members disagree about the care of an incapacitated patient?
  2. Who should make end of life decisions?
  3. How do you discuss end of life care with patients?
  4. How can you help the family of a dying patient?
  5. Who has the legal right to make medical decisions?
  6. Who is the appropriate surrogate to make decisions for the incapacitated patient?
  7. What are the first signs of your body shutting down?
  8. Why does a dying person linger?
  9. What is the main issue in end of life decisions?
  10. What do end of life patients say?
  11. Should Doctor tell patient they dying?
  12. What is the nurse's role in end of life care?

What will happen if a patient's family members disagree about the care of an incapacitated patient?

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.

Who should make end of life decisions?

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.

How do you discuss end of life care with patients?

Before you begin the conversation about hospice or palliative care, several practical details should be carefully considered:

  1. Make time. ...
  2. Make space. ...
  3. Turn off your cell phone and pager. ...
  4. Find out what the patient knows. ...
  5. Listen carefully to the patient's response. ...
  6. Discover the patient's goals.

How can you help the family of a dying patient?

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.

Who has the legal right to make medical decisions?

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.

Who is the appropriate surrogate to make decisions for the incapacitated patient?

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.

What are the first signs of your body shutting down?

You may notice their:

  • Eyes tear or glaze over.
  • Pulse and heartbeat are irregular or hard to feel or hear.
  • Body temperature drops.
  • Skin on their knees, feet, and hands turns a mottled bluish-purple (often in the last 24 hours)
  • Breathing is interrupted by gasping and slows until it stops entirely.

Why does a dying person linger?

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.

What is the main issue in end of life decisions?

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.

What do end of life patients say?

Tips for Talking with Someone Who is Dying

  • Tip # 1: Follow the dying person's lead. ...
  • Tip #2: If possible, be clear that you know the end is nearing. ...
  • Tip #3: Deal with regrets by saying, “Please forgive me.” ...
  • Tip #4: Free yourself of hard feelings by saying, “I forgive you.” ...
  • Tip #5: Appreciate the person's legacy by saying, “Thank you.”

Should Doctor tell patient they 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.

What is the nurse's role in end of life care?

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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