Planning

Advance Care Planning – A process that enables individuals to make plans about their future healthcare while they are healthy enough to consider options, make choices, and discuss with chosen support/agents. Making a living will/medical directive and naming a healthcare agent (Medical Power of Attorney) are part of advance care planning.

Advance Directive/Living Will – A document in which a person specifies what action should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. The instructions specify life sustaining procedures intentions and artificial nutrition and hydration. It can include a Values Statement and instructions for final arrangements, including body disposition.

Medical Durable Power of Attorney – A document that designates a healthcare agent to act on your behalf with regards to specific healthcare decisions- often designated in a comprehensive Advance Healthcare Directive or in a Living Will. The document is revocable- it can be changed. Agent powers end at death.

Proxy – Allows for appointment of an agent if one has not been named. A physician has the responsibility to gather all interested parties who then choose one to represent. The Proxy (surrogate) has limited powers and must act according to your wishes and values.

General Durable Power of Attorney – A document that designates a person/agent to act on your behalf with regards to specific financial decisions. “Durable” refers to the fact that the agent retains this authority even if the person who created the durable power of attorney becomes incapacitated. Your agent’s power ends when you die.

 CPR (Cardiopulmonary resuscitation) – An emergency procedure used to revive a person if their heart has stopped, or they aren’t breathing.

DNR (Do Not Resuscitate) – Tells healthcare professional not to use emergency life-saving procedures such as CPR, chest compressions, breathing tubes, and cardiac drugs.

 DNI (Do Not Intubate) – Allows basic life-saving CPR, chest compression, and medications, but specifically prohibits the placement of a breathing tube if their heart stops or they stop breathing. Usually contained within a DNR order.
Nutrition and hydration – Providing food and fluid to patients when they are unable to eat, usually via a feeding tube or intravenously.

MOST (Colorado Medical Orders for Scope of Treatment) – A doctor’s order that defines what specific life sustaining medical interventions a person should or should not receive if they are unable to communicate.

Hospice Care – Provides services at place of residence. Hospice requires an order by the physician to certify the patient has fewer than 6 months to live if the disease follows its usual course. Care is provided by a team that typically includes doctors, nurses, home-health aides, social workers, and chaplains. Hospice provides medications, equipment (wheelchairs, hospital beds), education and emotional and spiritual support.

Palliative Care – Treatment focuses on easing pain and discomfort, reducing stress to improve a patient’s quality of life, both physically and emotionally. Palliative care can be received while receiving curative and therapeutic care for an illness, such as chemotherapy, dialysis or surgery.
Holistic services – May include special treatments (music therapy, massage, pet visit, reiki, acupuncture) that address the whole patient, not just the disease.

Palliative sedation – Relieving suffering in a patient by sedating them, sometimes to the point of unconsciousness.

VSED (voluntarily stopping eating and drinking) – To hasten one’s death. It is legal in every state and does not require a terminal diagnosis. Best practice is with 24 hour support. Additional information is available https://compassionandchoices.org/our-issues/vsed/

Medical Aid in Dying – The process by which a terminally ill person, over the age of 18, with decisional capacity, obtains a prescription from a doctor that they can self-administer. Must be a resident of Colorado. Eligibility must be certified by 2 clinicians. Colorado End-of-Life Options Act passed in 2016.

End of Life Options Colorado – A state-wide non-profit organization that provides education and resources for anyone who wants to learn about their end-of-life choices.