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As I watch my mother (88 years) in ICU, I wonder at the emotional roller coaster and decisions that the doctors are asking my father to make day by day about "next steps". When we have conversations with them, they always act like there is a path to recovery, but it doesn't look like that to me. One day is better than the next and those are the days they ask if we should take the next surgical step to keep her alive. I never want to put my caretakers in the position of wondering what to do - I want to write detailed instructions as to when they should let me go. With the doctors always suggesting the next "hope", how can I predict what condition allows my loved ones to say enough? How can I write up thought provoking questions so that they make the right decision to allow me to go so they can live their lives?

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There is a form you can complete called Five questions. You can find out more about it by doing a search on 'five questions and end of life care'. Most states accept it and it is flexible and allows you to be more specific as needed. If you call your local hospital, they likely have it available.
Near the end of my Mom's life I sought cousel from a cousin who had worked in a CCU. Naturally, she couldn't tell me what to do but she did describe how some families find it so difficult to let go and how she saw older fragile patients be resusitated over and over. One 90+ person was resusitated 5 times in 4 hours before she passed. This helped me to retain my Mom's DNR!!!
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Thank you all for the answers. The hardest part is understanding all the different options there could be. In my other question about ICU care, it was mentioned the question to ask, "What would you do if this was your mom?" I imagine the first statement would be to define your own quality of life. Then ask you loved ones to share that with the Dr. and Nurses and ask them to answer all the questions with that in mind. Then provide as many situations as possible. Thanks, this has been a helpful forum.
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Start with a standard form, and add any other personal wishes. For example, it was very important to my husband that his brain be donated for research and he stated that in his healthcare directive.

But realize that however thorough you try to be, no one can anticipate all circumstances. That is why it is important to have as your healthcare POA someone who knows you well and knows your general attitudes, if at all possible.

I knew that my husband didn't want his life extended artificially, and he had a DNR in place. But what about the time he had stomach pain and blood in his stool? I stayed with him and comforted him and then asked him, should I call 911? And he wanted that. But what if had not been conscious? What if I had to make that decision on my own? Yikes! The paramedics took him to the hospital where he was treated for a bleeding ulcer and he lived another 8 years, most of them with a fair quality of life.

Do your best to be comprehensive, but realize there may be judgment calls regardless.
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coracora, excellent idea, too bad this idea was due to what your parents are going through.

I had an Elder Law Attorney draw up a Living Will and Advance Medical Directive [same as what Pam had mentioned above]. My Attorney also did a "Memorial Instructions" for who, what, where, and when when I finished my last chapter.

One thing I need to check with my Attorney regarding my Living Will is CPR. I would want CPR unless I am already in a terminal condition and it is time to let me go.

I had put together a large 3-ring binder for my parents to fill out regarding legal papers, elder care, wills, final plans, etc. Of course, when my parents had passed, not one question had been answered... [sigh]. Here were some my questions:

If you can no longer be independent in your own home, what do you wish to do? Would you prefer to live at home to hire a professional certified trained caregivers to help during the day/around the clock? Do you wish to hire cleaning people?

Or do you wish to move to a retirement community where you will get full-time trained professional care, quick medical help, and be around people of your generation and to enjoy what is offered by the facility?

Do you have long-term health care insurance? If so, name, account #, address and telephone number.

The list goes on and on.
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Look for a "Living Will" and "Advanced Care Directives". Find a form you like and sign it in front of your MD and two witnesses.
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