For some terminal diseases, it is not easy to die.
By the time people reach Advanced Dementia, they cannot tell others what treatments they do, or do not want. The reason: they will have lost mental capacity to make decisions.
They may survive a long time and their dying may be prolonged. The reason: They may only need help from another person with hand-feeding and hand-hydrating to continue living. They may not depend on high-tech medical treatment. They may have “No Plug to Pull.”
The challenge is how to let these patient die of their underlying disease.
The “Natural Dying Living Will” strives to overcome these challenges. It can work for any terminal illness. It focuses on the most compelling reason to allow a person to die: severe suffering.
This online program, “Begin to Plan for a Better Ending” is an excerpt of the full online program that can generate your “Natural Dying Living Will.”
A similar program can be used by relatives of patients who have already reached advanced dementia but whose living wills are not effective.
Both online programs use a patient decision aid, “My Way Cards.” It describes about 50 conditions.
First the cards educate you about advanced dementia and other severe illnesses.
Then the cards help you memorialize difficult end-of-life decisions.
The cards use words that are easy-to-understand. Each condition is made clearer by having anillustration.
Try the excerpt of the program by answering one question for each condition:
“Would this condition cause suffering so severe that you want others to allow you [or you loved one] to die to die of your underlying disease?”
This excerpt includes 12 conditions.
You will be emailed a print-out of your responses.
Unlike the full program, Begin to Plan does not strive to comprehensively reflect what people dread most about prolonged dying in advanced dementia and other terminal illnesses.
But Begin to Plan can help you answer:
==> Can My Way Cards help you make difficult end-of-life treatment decisions?
==> Can the printout of your Natural Dying Living Will excerpt adequately inform others what you want, and when... in a clear and specific way (and avoid conflict)?
==> Can “Natural Dying” be an effective intervention that allows you [or your loved one] to die, even if you have “No Plug to Pull”?
==> Do you want to use the full program for your own planning (“Strategic Advance Care Planning”)?
==> Do you want to use the full program for your loved one (“Now Care Planning”)?
To briefly explain Now Care Planning: The patient decision aid asks you to express your opinion for each condition by answering: “What would your loved one want, based on his/her values?” You would serve as his/her proxy, agent, or surrogate decision-maker.