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Joan Rivers Tragedy Spotlights End-of-Life Decisions

By    |   Monday, 08 Sep 2014 10:13 AM

Joan Rivers was the most energetic 81-year-old you could imagine. Her work schedule would have worn out people half her age. Suddenly, while seeming to be the picture of health, she suffered cardiac arrest while under sedation for a minor medical procedure. She was put on life support and eventually died on Sept. 4.
 
The comic legend’s without-warning death should motivate people to put their end-of-life instructions in writing before it is too late, a top doctor tells Newsmax Health.  
 
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“What happened to Joan Rivers should be a wake up call for the baby boomer generation which too often thinks, ‘I’m fine, I’m doing wonderfully well. I don’t have to worry about such things,”’ says Marc Leavey, M.D.
 
“This is a real problem for a generation that likes to think young. They have to be realistic and consider the question: ‘What if something happens to me and I don’t come out of it?’” added Dr. Leavey, an internist at Mercy Medical Center in Baltimore.
 
Shortly before her death, the machines keeping Rivers alive were disconnected so that she could die peacefully surrounded by family, according to reports. Her daughter Melissa is thought to have made any decisions in accordance to Rivers’ wishes. The pair was very close and Melissa was Rivers’ only child.
 
Written end-of-life instructions make it much easier for family to cope when a loved one is dying, Dr. Leavey said.  
 
Instead of making a heartbreaking decision that could leave regrets, loved ones are able to follow the patient’s specific instructions with a clear mind, knowing it’s what they want, said Dr. Leavey.
 
And contrary to popular belief, end-of-life instructions don’t always specify that a patient doesn’t want to be kept on life support. Often, they stipulate “Do everything you can for me,” Dr. Leavey said.
 
End-of-life instructions are usually put into a document known as an advance directive. It can include:
 
·         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 healthcare 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.
Sometimes family conflicts arise during such times and it is possible for such documents to be overridden or ignored. But, says Dr. Leavey, “At least people know what your wishes are, and that, if they do, they are going against your wishes.”
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Above all, it’s important to give tell family members about your wishes and give copies of your advance directive to your doctor and to the person who has your medical power of attorney. Says Dr. Leavey: “Too often these documents are found afterwards in a safe deposit box, and by that time it’s too late.”
You can find resources that will help you with end-of-life planning at caringinfo.org, a website run by the National Hospice and Palliative Care Organization.

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Joan Rivers was the most energetic 81-year-old you could imagine. Her work schedule would have worn out people half her age. Suddenly, while seeming to be the picture of health, she suffered cardiac arrest while under sedation for a minor medical procedure. She was put on...
joan, rivers, living, will, life, support
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2014-13-08
Monday, 08 Sep 2014 10:13 AM
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