Recently the world mourned the loss of comedic legend Joan Rivers. I must admit, the sudden passing of this truly wonderful woman personally saddened me. At the age of 81, her work schedule was more demanding than that of people half her age. In fact the night before she went into cardiac and respiratory arrest following a vocal cord procedure at Yorkville Endoscopy, Joan was working on stage in New York. Then came the unthinkable announcement that this active, vibrant woman was on life support. This tragedy serves as a startling reminder of our own frailty and brings to mind an important question: Do you have end-of-life care issues in order?
Joan Rivers' recent medical condition required her daughter, Melissa Rivers, to make perhaps the most difficult decision of her life. Joan had previously given Melissa a power of attorney, authorizing her to make medical decisions if and when a time came that Joan could not convey her wishes herself. Melissa took Joan off of life support.
Several years back I was faced with the same sad task of making a life-ending decision. I was engaged at the time, and my fiancé developed a brain tumor. At the time he had been misdiagnosed with Bells Palsy, and unfortunately, by the time we found out that he had a hidden brain tumor, it was already too late. All the radiation and chemo could not help him in the end. He lay in a medical bed for a year without speaking, with the only thing keeping him alive being machines and an IV - not the way he would have wanted to live. I will never forget the guilt that weighed on me as I made the decision to let him go, and I am still haunted by it often. My thoughts are with Melissa.
Prior to my fiancé's passing, I did all the necessary paperwork with an attorney, which constituted the following:
A living will. This tells your doctor how you want to be treated if you are dying or unconscious and cannot make decisions about emergency treatment. You can stipulate which procedures you would want, which ones you don't, and under which conditions each of your choices applies.
A durable power of attorney for health care. This legal document names a health care proxy, which is someone, such as a family member, that you give the authority to make medical decisions for you when you are not able to do so.
A DNR or "do not resuscitate" order. This document tells the medical staff in a hospital or nursing facility that you do not want them to try to return your heart to a normal rhythm if it stops or is beating unevenly. You can also execute a non-hospital DNR to keep ambulance personnel from resuscitating you. There are similar forms for CPR and also a DNI (on not intubate) order if you do not want to be put on a breathing machine.
Relieving them of any doubt about your wishes, settling your end-of-life care issues is the best gift you can give to your loved ones.