Carol's Health Care Directive

May 1, 2004 Version


    This document is an addendum to my Health Care Power of Attorney and is intended to illustrate, not replace, that document.  Should I become unable to clearly communicate, either verbally, through writing or some form of gestures, etc., my wishes for my health care, this is the general idea of what I would want done:

Summary:  Please take these instructions as my attempt to communicate my general wishes.  If what I have put in writing is contradictory with what my health care agent(s) as identified in my Health Care Power of Attorney believes I wish, then what he/she instructs has priority.  I also wish for the medical staff to take into account the context of when these events (i.e. heart stops) occur.  If a family member has expressed a desire to be with me when I die and is in the hospital, consider resusitating me long enough for that family member to return.  Because I am young and healthy (basically!), I wish to have care continued unless multiple things have gone wrong such that I'm not expected to live for more than a few weeks, or that the quality of that life might be pretty miserable and not bringing me back would be a kindness.

Nutrition: 
Please continue any and all forms nutrition, i.e. tube feeding, IV liquids, TPN (IV feeding) regardless of other conditions UNLESS I have become comatose, am not expected to regain conciousness and the only thing keeping me alive are the feedings.  At that point, please discuss when to discontinue nutritional/liquid support with my husband.  At that point, I am mostly concerned about staying comfortable.

Palliative Care:  Please continue any and all forms of care intended to make me more comfortable, such as pain control medication, medication to help control mental health concerns (i.e. anxiety, depression, psychosis), sleeping aids, massage, bathing, etc.

Intubation/Respirator or Other Ventilatory Support:  Please put me on a respirator or any other forms of breathing support if needed to help me recover from a short-term set-back.  For example, I am expected to survive at least a few weeks or longer and am expected to come off the ventilator at some point but need respiratory support in order to recover from a condition requiring ventilatory support.  OR I may not be expected to come off the ventilator but may regain conciousness enough to be able to communicate with family members before dying.

Cardiac/Breathing Resusitation:  Please resusitate me if my heart stops/I stop breathing UNLESS multiple problems are occuring simultaneously and I am not expected to survive for more than a few weeks.

    For example, I am DNR/DNI if one or more the following problems exists:

    1)  Major brain damage resulting in paralysis and inability to communicate, such as due to a stroke

    2)  Transplant failed and my own bone marrow has not recovered, plus nothing can be done to result in a working bone marrow (i.e. another transplant)

     3)  Major organ failure or damage to organ(s) that will ultimately be fatal short term (i.e. less than a month)

    4)  AML has returned and cannot be treated for some reason (i.e. refractory, I am too weak to survive chemotherapy)

    5)  Process of resusitating will result in brain damage or other damage that will result in my quality of life being severely diminished, i.e. in a coma, in severe pain, unable to communicate with family members

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