For some terminal diseases, it is not easy to die.

Advanced dementia is especially challenging.
People in advanced dementia cannot speak for themselves. They cannot tell others what treatments they want or do not want. The reason is they will have lost mental capacity to make medical decisions.

If caregivers help with spoon-feeding and spoon-hydrating, dying with suffering can be prolonged. Living wills that refuse only high-tech medical treatment may not help since advanced dementia patients may have “No Plug to Pull.”

So caring loved ones may not know how to allow them to die of their underlying disease.

The “Natural Dying Living Will” strives to overcome this challenge. It can work for any terminal illness. It focuses on the most compelling reason to allow a person to die: severe, untreatable suffering.

This online program, “My-Way-Cards-for-Dementia-Demo” is an excerpt of the full online program that can generate your “Natural Dying Living Will.”

Another, similar program can help patients who already have reached advanced dementia but lack an effective living will. It is called NOW Care Planning. A group of people who are concerned about the patient's suffering can complete the survey by expressing the responses they believe the patient would have given--if asked when s/he still had the mental ability to do so.

Both online programs use a patient decision aid, My Way Cards” that describes 50 specific conditions.
The cards describe what it can be like to live with advanced dementia and other terminal illnesses.

Each card/condition asks people to JUDGE how much suffering the condition would cause. The words are easy-to-understand and each card has a clarifying line drawing.

This DEMO has 12 conditions; the full program has 50 as it strives to be comprehensive.

Use the DEMO if you want to learn:

==> Can My Way Cards help you make and memorialize difficult end-of-life treatment decisions for yourself or another person?

==> Can your printed Natural Dying Living Will clearly and specifically inform others (especially your future physician) what treatment you want, as it prevents future conflict?

==> Would you consider “Natural Dying” as an effective way to reduce severe suffering that can allow you to die if you have “No Plug to Pull”?

==> Would you consider “Moderate Anesthesia” as an effective way to reduce exceedingly severe suffering--if non-sedating ways to reduce your suffering have failed, so you are currently living in the “Dementia Gap”; that is, you can still eat and drink without help from another person, which makes Natural Dying unavailable as an end-of-life option.

==> Do you want to use the full program for your own planning (“Strategic Advance Care Planning”)?
OR,
==> Do you want to use the full program for a loved one who has already reached advanced dementia but lacks a effective living will?

Note: If you want another person to experience this DEMO, here is the shortcut link for them to use: tinyurl.com/MyWayCardsDEMO

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* 1. What is your primary interest in completing this demo?

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* 2. Enter the date (MM/DD/YYYY) you used the My Way Cards patient decision aid.

Date

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* 3. You have two choices: You can remain anonymous and give yourself a nickname. Or you can enter your real name and contact information near the end of this program, to receive a copy of the decisions you made.

You can contact Dr.Terman by email at DrTerman@CaringAdvocates.org.
If urgent, you can TEXT him @ 760 704 7524.

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* 4. How much information do you want, now?

Reading about these topics is OPTIONAL -- CLICK on the second, "I prefer to skip..." option below to save time by going directly to 12 examples of My Way Cards. (You can always come back later, or you can read this information in the full patient decision aid):

==> What are the general goals of living wills?

==> Why may traditional living wills and most "dementia-specific" living wills may not be effective for advanced dementia?

==>
What can actually be unnatural about feeding and hydrating and how it differs from eating and drinking.?

==>
Why "Natural Dying" can really be a peaceful way to die that is clinically appropriate, legal, ethical, and moral--as long as food and fluid are always placed within the patient's reach?

==> How does "Moderate Anesthesia" differ from palliative sedation? Can it be a peaceful way to die that is clinically appropriate, legal, ethical, and moral?

==> What happens after you judge how much suffering each of 50 conditions would cause? Why you need multiple powerful strategies to attain your a private, peaceful, and timely dying?

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