Abstract: Advance care planning has become a much touted and potentially very important addition to the new operative structure of meeting the many challenges of an ever increasingly older population. From what used to be discussions about CPR and DNR the process has evolved into what many expect might become the basis of end-of-life decision-making that may assist family members and health care providers to meet the needs, wishes and priorities of the elderly population, particularly when they are nearing that last trajectory of life.
Key Words: Artificial nutrition and hydration, advance care planning, living wills, end-of-life planning.
1. Planning before there is a medical crises can help avoid medical decisions that may not be in keeping with your wishes and values.
2. Artificial nutrition and hydration may not be what you really want, even though in its simplest form it may seem desirable as a way of avoiding death.
Communication with those who will be responsible for decision-making when you are no longer able to do so is key to having your end-of-life wishes fulfilled and should not be left to crises situations.
If you have favorite foods, make sure your substitute decision-makers know about them so that when the time comes you will not be deprived of your most enjoyed foods, because some health care provider deems them to be "unhealthy" or not in keeping with an "optimal diet".
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Later Stage Dementia: Promoting Comfort, Compassion and Care
Michael Gordon, MD, MSc, FRCPC, Medical Program Director, Baycrest Geriatric Health Care System; Professor of Medicine, University of Toronto, Toronto, ON.
When it comes to dementia much of the focus is related to diagnosis and treatment(s). A terminal phase is not always considered with conditions that cause dementia-but must be to properly plan care.
To address clinical and ethical challenges that face health care providers and families for this population and to provide health care providers with processes by which to address such ethical dilemmas.