Possible Directions To Your Carers When You Are Terminally Ill
Possible Directions To Your Carers When You Are Terminally Ill
from "To Die Well" by Dr Sidney Wanzer 2007, adapted by Dr Libby Wilson 2008
Introduction
If you are suffering from a terminal illness, there will come a time when further attempts to cure your disease are futile and may cause you further suffering. It is important that you ask your doctor to be frank and realistic about this. It may be that a further course of treatment might prolong your life by a few weeks or even months but this could be at the cost of unpleasant side-effects which may make you feel more ill than you do at present.
YOU decide the time when the purpose of medical care is no longer to cure or modify your disease but to help you live as comfortably as possible in the time you have left – this is usually termed palliative care.
The following are suggested instructions, all or some of which, you could ask your carers to observe.
1) Nothing is to be done which prolongs the dying process
2) In the event of a cardiorespiratory collapse, no CPR, respirator or other resuscitative measures are to be used
3) No antibiotics are to be administered for urinary tract, chest or other infections
4) No intravenous fluids (including blood transfusions) are to be given
5) If dehydration occurs, it is not to be treated by administration of fluids via any route unless I request water to drink but I am not to be urged to drink fluids
6) No naso-gastric tube is to be used *
7) Pain or any other form of distress or agitation is to be treated with medication in sufficient doses to relieve the symptoms, even if the dose might shorten life.
8) No transfer to hospital is to be made**
9) There is no need for me to get out of bed or sit up if I do not wish to do so.
10) No laboratory tests, x-rays or vital signs (temperature, respiration, pulse rate) are to be done
* Dying patients do not want to eat and desire to drink becomes minimal which results in dehydration. This shortens the dying process which may be regarded as a benefit.
** Patients who are dying in their own homes with proper supportive care are probably the lucky ones. Those in nursing homes and hospices should also not be moved but it is important to make your wishes clear and specific to those in charge. Reinforcement by your family and friends should ensure that they are followed.
from "To Die Well" by Dr Sidney Wanzer 2007, adapted by Dr Libby Wilson 2008
from "To Die Well" by Dr Sidney Wanzer 2007, adapted by Dr Libby Wilson 2008
Introduction
If you are suffering from a terminal illness, there will come a time when further attempts to cure your disease are futile and may cause you further suffering. It is important that you ask your doctor to be frank and realistic about this. It may be that a further course of treatment might prolong your life by a few weeks or even months but this could be at the cost of unpleasant side-effects which may make you feel more ill than you do at present.
YOU decide the time when the purpose of medical care is no longer to cure or modify your disease but to help you live as comfortably as possible in the time you have left – this is usually termed palliative care.
The following are suggested instructions, all or some of which, you could ask your carers to observe.
1) Nothing is to be done which prolongs the dying process
2) In the event of a cardiorespiratory collapse, no CPR, respirator or other resuscitative measures are to be used
3) No antibiotics are to be administered for urinary tract, chest or other infections
4) No intravenous fluids (including blood transfusions) are to be given
5) If dehydration occurs, it is not to be treated by administration of fluids via any route unless I request water to drink but I am not to be urged to drink fluids
6) No naso-gastric tube is to be used *
7) Pain or any other form of distress or agitation is to be treated with medication in sufficient doses to relieve the symptoms, even if the dose might shorten life.
8) No transfer to hospital is to be made**
9) There is no need for me to get out of bed or sit up if I do not wish to do so.
10) No laboratory tests, x-rays or vital signs (temperature, respiration, pulse rate) are to be done
* Dying patients do not want to eat and desire to drink becomes minimal which results in dehydration. This shortens the dying process which may be regarded as a benefit.
** Patients who are dying in their own homes with proper supportive care are probably the lucky ones. Those in nursing homes and hospices should also not be moved but it is important to make your wishes clear and specific to those in charge. Reinforcement by your family and friends should ensure that they are followed.
from "To Die Well" by Dr Sidney Wanzer 2007, adapted by Dr Libby Wilson 2008