Advance Directives… Worth Pondering

This past week, I gave my Advance Directives talk to my group. I try to give it on a Friday, so that my patients can think it over and bring questions on Monday. Over the years, I have had many patients call me and ask when I am giving that talk again so they can hear it once more. I make it a point not to push my personal views onto anyone, I just present the facts. One hundred years ago, it was simple: there were no ventilators, no long ICU stays, no paramedics rushing people to ER’s. Even 50 years ago, the options were limited. Iron lungs were used in the 50′s ( it is estimated that there are about 8 people in the U.S. who are still on one) for polio. Other ventilators were being developed in the 1950′s, mostly for surgery and post-operative use. Fast-forward to today, and the choices can be downright dizzying. I don’t believe that anyone should have to suffer at the end of life. Yet, our powerful ventilators make it possible to prolong life…. and not without side effects. So the question shifts from, “If you can’t breathe on your own, do you want to go on a ventilator?” to: “Do you want to try non-invasive (mask) ventilation for a while, and if that doesn’t work, a regular ventilator, and if we can’t get you off that, we’ll put in a tracheostomy tube and send you home on a smaller ventilator, and your family can learn to care for you”. ? This is the piece I think is missing in Advance Directives. People check boxes on pre-printed forms, intended to make the decision-making process easy, and they have no idea what they are saying ‘yes’ to, and nowhere to turn for definitive answers. For more on this subject, see my short video by clicking here. Or, join  COPD Success.com for the full lesson.