Have any questions about how to use the community? Check out the Help Discussion.

NY Times guest opinion essay on paradox of PWD and advanced directives

dancsfo
dancsfo Member Posts: 295
100 Comments 25 Care Reactions 25 Insightfuls Reactions 25 Likes
Member

The NY Times has an interesting article about advanced directives and PWD.

Whose wishes ought to be honored 1) the pre-dementia person who wrote the directive, or 2) the current PWD?

(the shared gift article link is valid for 30 days)

Comments

  • storycrafter
    storycrafter Member Posts: 273
    Ninth Anniversary 100 Comments 25 Care Reactions 25 Likes
    Member

    Well written article brings up an interesting and important question. Thank you for the link!

  • M1
    M1 Member Posts: 6,788
    1,500 Care Reactions 1,500 Likes 5000 Comments 1,000 Insightfuls Reactions
    Member

    Very well written, I've seen other articles by him. But it challenges the whole concept of advanced directives-why bother writing them in advance if you're not going to honor them?

  • Iris L.
    Iris L. Member Posts: 4,370
    Legacy Membership 2500 Comments 500 Likes 250 Care Reactions
    Member

    This doctor is struggling with the same struggles that members post about in the very late stage. It could help him to read the book, Hard Choices for Loving Families.

    Iris

  • dancsfo
    dancsfo Member Posts: 295
    100 Comments 25 Care Reactions 25 Insightfuls Reactions 25 Likes
    Member
    edited October 2023

    Thanks for referencing other articles written by Dr. Sandeep Jauhar in the NY Times. I also found his book and interviews (see link below) with him when he wrote his memoir on his experiences. I think that even a physician (he is a cardiologist) struggles with these issues (e.g. the discussions he had with his siblings) shows that it is not an easy issue to deal with.


  • SusanB-dil
    SusanB-dil Member Posts: 1,129
    1000 Comments Third Anniversary 100 Likes 25 Insightfuls Reactions
    Member

    Thank you for posting that.

    It would seem to me that the father knew exactly what he meant when he wrote about "a meaningful life" - and it seems that his life was still meaningful - albeit that 'this' may not quite have been what his father meant at the time. a bit of ice cream, spending time with friends and family... and he was content.

  • dancsfo
    dancsfo Member Posts: 295
    100 Comments 25 Care Reactions 25 Insightfuls Reactions 25 Likes
    Member
    edited November 2023

    There is a follow-up set of letters to the editor with good observations. This is a complex issue. One letter stated: "Advance care planning is inherently problematic given that we cannot predict our future ailments and, importantly, cannot predict how we will feel about our quality of life when we’re afflicted with serious illness."

    and referenced that Dr. Barak Gaster, who has published a now widely used Advance Directive for Dementia which addresses life-support choices in the various stages of dementia, that is free to download and use. The New York Times article from 2018 on this directive is here.

  • Quilting brings calm
    Quilting brings calm Member Posts: 2,444
    500 Likes 1000 Comments Fourth Anniversary 250 Insightfuls Reactions
    Member

    It seems to me that the author of the article was experiencing denial or an inability to say ‘it’s time’. These are his issues, not his father’s. His father made a decision at a time in his life when he was fully capable of understanding how his world would shrink and he didn’t want that -for himself or his family.

    Thankfully the brother honored the advance directive. My mom has asked for this and I will honor it.

    I’d like to read an article where the struggle is the other way- an advance directive that wanted everything possible done- and the patient is now in a condition that makes that directive problematic or ill advised. Such as dementia or a situation involving intubation, feeding tube, severe stroke, etc. my step-father is so wishy washy on the subject. Says he doesn’t want to continue to see doctors, or have invasive procedures, but also statesmd he wanted a full code if his heart stops ‘and they can fix it’.

Commonly Used Abbreviations


DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
Read more