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 do or do not want. The reason: they will have lost mental capacity to make decisions.
They may survive a long time. Their dying may be prolonged. The reason: To continue living, their only need may be to accept help from another person's hand for spoon-feeding and spoon-hydrating.
Most living wills refuse high-tech medical treatment to avoid prolonged dying with suffering.
But advanced dementia patients' live may not depend on them. They 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 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,” and a similar program used to help patients who already have 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.
The cards can educate you about advanced dementia and other severe illnesses.
The cards help you make and memorialize difficult end-of-life decisions. Their words are easy-to-understand and each condition has a clarifying illustration.
You complete your task by answering one question for each condition:
“Would this condition cause suffering so severe that you want others to allow you to die to die of your underlying disease?”
This excerpt of the online program, Begin to Plan, includes 12 conditions. (Note: the full program strives to comprehensively reflect what people dread most about prolonged dying in advanced dementia and other terminal illnesses.)
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 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”)?
OR,
==> Do you want to use the full program for a loved one who has already reached advanced dementia but lacks an adequate and effective living will (“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.