End of Life

Is this the same as Power Of Attorney? We have one for Finance and one for Health and I think there are a fair number of people who now have them, now that we are more clued up about procedures. Are you in the US?

No, Situp, I'm in England.

There is a lasting power of Attorney regarding one's financial affairs. There is the separate Advance Decision (or 'Advance Directive' or 'Living Will' regarding one's end of life wishes. The extra bit |I am on about was news to me when I heard about it on The Big Questions on BBC1 TV on Sunday.

This is about how you can be kept alive by artificial means and cannot stop them doing it because you are unconscious. Your named Welfare Attorney can stop them on your behalf ans allow you to die. Probably few of us want to be kept alive and terminally unconscious for years.

We have a separate POA for that, I’d have to dig it out to see what the official name of it is, but we did it at the same time as the Financial POA.

You can write this into the LPA for Health & Welfare as SUS said.

Has this been tested in court? I know that itisn't possible to get life support turned off if you are a relative and i wonder if doctors would take notice of a Wefare Attorney. If you have an elderly reative in hospital do discuss with them having a Do Not Resuscitate in their file. We did this for my mum and I am so pleased we did. She died suddenly in hospital from pneumonia, it was quick and peaceful. If she hadn't had the DNR she would have been subjected to all the resucitation torture and probably lingered on machines for a few days. It's a hard conversation to have but so worth it.

Trisher, if you view that The Big Questions on BBC iplayer, you'd get a better idea of it than I can explain. However Compassion in Dying makes it clear that the advance decision (living will, advance directive) including the decision of one's Welfare Attorney is legally binding.

compassionindying.org.uk/

I think I have misunderstood . The LPA for Health and Welfare is maybe not an addendum to the Advance decision, but is a separate document. I wish that an official from Compassion in Dying would join in this conversation. However, their website is good.

That is interesting Alexa thanks for the link, but amazingly complicated, as you have to say exactly which conditions you do not wish to be treated for. So if you have a stroke and you have only mentioned heart attacks it will still happen.

Trisher, I agree it seems complicated for the reason you say. However you can generalise as serious illnesses and accidents sometimes share the same signs symptoms and prognoses.For instance :

1.terminal condition

2. intractable pain

3. irreversible vegetative state

4. Irreversible anything else which destroys quality of life.

I'm no expert, and I guess it's best to discuss with doctor which generalities apply.

BTW Im afraid that it costs about £83 or thereabouts for lasting power of Attorney, whereas the Advance Decision does not involve any money apart from printing. Also my GP asked for £20 for signing and placing my Advance Decision certificate with my medical notes.

Extract from Compassion in Dying's website:

What do an Advance Decision (Living Will) and an LPA cover?
An Advance Decision covers refusals of medical treatment. It also only applies to the treatments and circumstances that you write about in the form. It won’t apply if you’re in a situation that isn’t covered in your Advance Decision.

An LPA allows your attorney to make any decision about your health and personal welfare. This includes where you live and how you’re cared for, your diet and what you wear as well as decisions about medical treatment.

Who makes decisions for me if I make an Advance Decision (Living Will) or an LPA?
In an Advance Decision, you make a refusal of medical treatment. It’s in your own words.

In an LPA, your attorney will make decisions on your behalf. You therefore need to trust your attorney to understand your wishes, respect your values and be able to make the best decisions for you.

How much does it cost to make an Advance Decision (Living Will) and an LPA?
It’s free to make an Advance Decision. It currently costs £82 to register an LPA, but some people with low incomes or on certain benefits can pay a reduced fee.

Trisher, it seems that whereas the Advance decision form requires some detail, the other form the Lasting Power of |Attorney for Health and Welfare can decide as if they were you yourself.

I see that Compassion in Dying say that AgeUK will send a knowledgeable volunteer to help with these forms. My son helped me with the Power of |Attorney for financial stuff and he is good at such things however there will be people who feel they need help from someone else.

Thanks Alexa they don't make things easy do they?

Trisher, it's a minefield! But |I know I ought to pick my way through it at least for my sons' sakes. They are themselves getting older and someday sooner rather than later they may be the better of naming their own person to hold lasting power of attorney should they be so disabled they cannot choose for themselves. God forbid! But life is such a mean bitch.

I have given my two daughters POA for Health and Welfare, as this has morevlegal force than an Advance Decision. However, I am planning to do the Advance Decision too, as this would put my wishes into writing and make it easier for them to make a choice on my behalf, should the need arise.

The recent death of an elderly relative has taught me quite a bit about such matters. In particular, these documents are not much use if there's a only single copy shut in your filing cabinet or in your solicitor's office. It needs to be easily and quickly accessible to those who might have to make the decisions (e.g. you are found unconscious after a heart attack). The attorneys, the GP, and any hospital consultants or . nurses who are caring for the person also need to know of the existence and whereabouts of the documentation.

As a friend of mine said, the paramedics called if you have an accident or attack will not be looking at your paperwork. They will do whatever they think is necessary. I think the question then is if you are on life support machines who will make the deision to request they be turned off. It's actually not something I would want my DSs to be responsibe for, no matter how much they knew it was what I wanted I think the decision would stay with them for many years.

These are different from LPAs. I think that, if they are signed, dated and witnessed, they are legally valid and should be lodged with your GP and your Health and Wellbeing Attorney.

Grannyticktock, some very good advice there from someone who has the experience. I hesitate to add to what you wrote but here goes: the Advance Directive and the Power of Attorney for Health and Welfare affect each other in different ways according to which is first in situ. I learned this from one of the websites about end of life choices, either Compassion in Dying or AgeUK.

Ticktock if you would recommend this small practical point. Where do you store these documents in your home? This is not to be nosy but to help me keep mine in a suitable place so they can be found by paramedics and family. I already have a not very conspicuous little box labelled "Important Phone Numbers". I wonder if I should hang some sort of notice board on the wall with stickit notes. ??

Trisher, I think that you would want the paramedics to do their things which we have all seen many a time on TV. This is because, although those of us past a certain age would not mind dropping down dead , we don't want to be disabled by stroke or something. The paramedics will be doing only first aid until we are assessed in the hospital. Unless we have died of course in which case I don't know what the paramedics do with our remains as this has not been shown on Casualty.

Have you heard about 'message in a bottle'. Worth Googling - I'll try to find a link.

www.lions105sw.org.uk/district-projects/message-in-a-bottle/

Here it is!

Having had the sad experience of a very dear neighbour dying before my eyes, it was a very difficult and distressing happening to watch the paramedics treating my friend to try and bring her back to life. It has made me very determined to not allow the same to happen to me as I have always said that I do not want to be resuscitated, but how do you stop this as I realise that they, the paramedics, are only doing what they have been trained to do. In my friends' instance it made no difference, she was gone and I know in my heart that she wouldn't have wanted to live on with a limiting illness.

(Apologies to the pedants if the friends' apostrophe is in the wrong place, I am happy to be corrected. )

To answer your question Shandi - my mother has a DNR (Do Not Resuscitate) sign in a very prominent place in the first room in her house; this has been agreed with her GP and nursing team.

When DH was very poorly but still able to make choices our MacMillan nurse took him through the DNR discussion. There was a system where the signed form was placed in a bright yellow envelope which was left in a prominent place. Paramedic staff knew to look for the envelope should the need arise if they were called to the house. I think the system was a local one introduced by the palliative care team.

Thanks for your responses grannyactivist and alygran, that's reassuring to know. Now I need to action the advice.

Thanks Kittylester, I just ordered one. Very helpful.

Regarding shandi6570's experience and comment , is it so obvious when somebody has really died? It was obvious to Shandi. I have seen dead people and they looked dead very shortly after they passed away. Should it have been obvious to the paramedics? What I think I mean is; are paramedics able to confirm that death has occurred?

I wonder if Google knows.