I live in Houston and have worked as a nurse. I have a lifelong passion for traveling, nature, and photography (preferably all together!).
Making Your Wishes Known
Everyone who has reached an age sufficient enough to be making life decisions should consider getting a living will in addition to any other type of legal document one has secured. Those are also vitally important.
Please accept this bit of advice from the perspective of having been in the nursing profession. I have seen the good, the bad, and the ugly decisions that are made for people once they can no longer tell the doctors and other decision-makers what they might have wished regarding medical care for themselves.
I'll give you two examples of bad decisions, in my opinion.
Real Story Number One
This first story has to do with a terminal cancer patient that I attended as a private-duty nurse. It was one of the very few private-duty cases that I ever accepted, and I felt an obligation to remain on the case until the death of the patient. It was not easy! I'll call him Mr. Smith.
He was a lovely man with metastasized cancer that had spread over his entire body. Mr. Smith was most often in pain. His veins were poked and assaulted with so many intravenous fluids and medications that they were harder to find and keep open and free-flowing.
When they finally had to try to find some available veins in his feet because the other sites had been exhausted, he screamed out with pain. I elected not to inflict this suffering, and the floor nurses had to follow the doctor's orders instead.
Mr. Smith quite often hallucinated. So had he spoken to doctors about his wants and desires at that point, they probably would not have deemed his decisions lucid and worth following. Thus his family made the medical decisions for him, and they decided to prolong his life.
At the time, there was a severe blood shortage in Houston. I often wondered why they kept giving Mr. Smith blood when his case was terminal, and other people undoubtedly needed the blood to survive. I thought that this was a shame!
The odor coming from his room was horrendous. I understood why most of the other private duty nurses bailed out of caring for him. My stomach often lurched, and I never did vomit but most often had to fight that feeling each day when I first entered his room.
His family did come to visit him but never stayed in the room for long. They would gather and visit with each other in a nearby lounge. They told me to get them if anything rapidly deteriorated.
Mr. Smith's final relief came soon after his attending doctor gave me a verbal order (which I happily charted) to discontinue the I.V's when the next time came when his veins could no longer support one. The doctor was going on vacation and told Mr. Smith that he would see him in the next life.
When he was no longer able to receive fluids and medications, he quite peacefully slipped into a semi-comatose state and quietly died. All the many needless weeks of suffering had come to a close.
Had Mr. Smith had a living will (also called an advanced directive) and his intentions regarding care "above and beyond" the ordinary, especially if chances of a full recovery looked grim, this long-drawn-out scenario might never have occurred. His peaceful death could have come earlier, and he would have suffered far less pain!
Real Story Number Two
Another example goes back to my student nursing days when I volunteered to be in the hospital. They told me to sit with a patient that was in a private room and was in a full coma. He was hooked up to all kinds of medical paraphernalia, including a respirator. At that point in my desired nursing career, it was a bit scary for me!
His family wanted to "keep him alive" until family members from other parts of the country could get there to see him. Yes, his body was in that bed, but he was hardly alive in any other sense. He could not breathe on his own, and he was determined to be brain dead. The only thing moving was the heaving of his chest in time with the noise of the respirator.
Was this the life he would have wished for himself?
It did not take me long to realize that I did not want my life addressed like these examples at an end-stage. With a living will, one has choices. It is a simple form that can be signed and notarized. Make sure your family members or others that might be caring for you know of its existence. Give a copy of it to your doctor.
Whatever you decide to do, consider making your wishes known before any need. Don't get stuck in situations outside of your control. You might end up suffering needlessly, not to mention the ridiculous costs of ongoing medical care when there is no chance of a successful recovery.
Do an online search for living wills. You can print out forms that meet various state requirements and all at no cost. My heartiest recommendation would be that you protect yourself and make your wishes known today. Tomorrow could be too late!
Quality of Life Issue
We have a friend right now who is in the position of being able to follow her husband's wishes regarding end of life care. He is in his 90s and has numerous medical issues in addition to Alzheimer's Disease. Hospital visits are frequent. He can no longer swallow anything but small bites of pureed food. Presented to her is the idea of engaging hospice.
Doctors have floated the idea of installing a feeding tube. Thankfully our friend's husband has a living will that specifies that he does not wish to have a feeding tube, among other notations. He can no longer communicate effectively, given his present state. His decision to have a living will in place is making the choices easier for his doctor and wife.
It is a very loving thing to do for those who may have to make heart-wrenching decisions when caring for patients or relatives. Quality of life is at stake. It can often be of more importance than the length of life, especially if pain and suffering are involved.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2008 Peggy Woods
Comments are always welcomed.
Peggy Woods (author) from Houston, Texas on November 05, 2020:
Many people do not think of the importance of having a living will in place. As you wrote, it makes things so much easier for everyone, including the patient. Thanks for your comment about this important topic.
Rajan Singh Jolly from From Mumbai, presently in Jalandhar, INDIA. on November 04, 2020:
I fully agree with the points you raise in this article. No person would want to undergo immense pain when he cannot have a life free of basic support. Making a living will certainly makes things easier for all including the patient.
Peggy Woods (author) from Houston, Texas on October 10, 2019:
Having a living will is something that everyone should have in place. You will be happy that you did that, if and when a time comes when you can no longer express your wishes.
Dale Anderson from The High Seas on October 09, 2019:
Good timing on this because the missus and I are meeting with a lawyer in the morning to talk about such things as a Living Will.
Peggy Woods (author) from Houston, Texas on July 22, 2018:
The good thing about having a living will is that the person making that decision has a say in their own care at the end of life when they may or may not be in a position to express their desires. It can often relieve the people left behind to have to make those hard decisions. We have a personal friend who was comforted that her husband had made a living will when it was close to the end of his life.
Patricia Scott from North Central Florida on July 21, 2018:
Yes it is so important...just faced by someone very close to me in the past ten days. It was horrendous for the (adult) children to watch their Mother to suffer on and on. Thank you for putting out this important information. and by the way...you looked so cute in your uniform....I do remember nurses in those too. Angels headed your way ps
Peggy Woods (author) from Houston, Texas on January 01, 2015:
Hello Author Cheryl,
It is sad when things like that happen at the end of a person's life. You are correct in that the family members do not have to follow the wishes in a living will...but hopefully it nudges most people in the right direction.
Peggy Woods (author) from Houston, Texas on January 01, 2015:
It sounds as though you have taken some good precautions. In addition to a living will you could also have a DNR paper signed and notorized. Just some backup insurance for those who may have to make decisions on your part at the end of life.
Wishing you a very Happy New Year!
Peggy Woods (author) from Houston, Texas on January 01, 2015:
Hi Au fait,
This should be on everyone's 'to do' list because if not specified ahead of time, things might go very wrong at the end of one's life. Thanks for the share. Happy New Year!
Cheryl A Whitsett from Jacksonville, Fl on December 31, 2014:
I am a firm believer in having your documents ready in case of a circumstance that prevents you from making decisions. I have stood in the ICU and heard children arguing to keep their mother or father alive. I have witnessed a living will not being used properly and not carried out as the person wished. It's sad how selfish people are to the one that is suffering.
Mary Hyatt from Florida on December 30, 2014:
You have given some very good advice with this Hub. I certainly have a living will and I would hope my family honors my wishes. I also have a durable power of attorney. My family understands I never want to be placed on life support if there is absolutely NO hope.
Voted this Hub UP, etc.
C E Clark from North Texas on December 30, 2014:
Going to share this excellent article again. What better time than when everyone is planning their New Year's resolutions and other new beginnings to also take time to make a living will?
Hope your New Year is fantastic all year long!
Peggy Woods (author) from Houston, Texas on July 12, 2014:
You are absolutely correct. My husband and I have all of those documents in place for the "what ifs" in life that might crop up. Feel free to write your own hub on that subject regarding the durable power of attorney for healthcare and we could link them together. :) The living will does address those very last end of life decisions.
cfin from The World we live in on July 12, 2014:
Hi Peggy W,
A living will and a health care power of attorney are along the same line. A living will is only relevant to what may be done on ones death bed.
A durable power of attorney for healthcare, covers deathbed concerns and all other health care issues as well. Maybe adding a hub on Durable power of attorney for healthcare would work well ;)
Peggy Woods (author) from Houston, Texas on July 11, 2014:
Yes...sadly, it happens. That is one reason to have valid wills in place and also living wills which address end of life decisions while the person can still make their wishes known.
Kevin W from Texas on July 11, 2014:
I never knew family members could turn on each other so quickly until one died without a will. Nice topic. Thumbs up on your hub Peggy W.
Peggy Woods (author) from Houston, Texas on July 10, 2014:
Hi Au fait,
It is just one of those things that can make such a big difference at the end stage of a person's life and it is so simple to do. Thanks for the shares. Important topic!
C E Clark from North Texas on July 10, 2014:
Came back to pin this again and share it again too. It's an important subject that everyone should take seriously and then make a their wishes known through a living will.
Peggy Woods (author) from Houston, Texas on January 29, 2014:
Thanks Au fait. This is such an important topic.
C E Clark from North Texas on January 02, 2014:
With so many people making New Year's resolutions it seems like this would be a good thing to put on the list and get taken care of early in the year. Already pinned this to my boards, but will now pin it to 'Awesome Hubpages.'
Peggy Woods (author) from Houston, Texas on August 23, 2013:
Thanks for adding that important bit of clarification making the power of attorney document most effective. This hub is more about the living will but often people wish to combine documents such as these.
Peggy Woods (author) from Houston, Texas on August 22, 2013:
Hi Au fait,
Making out a living will is so very important! Thanks for your part in passing this information on to others.
cfin from The World we live in on August 21, 2013:
If you are making a power of attorney document, make sure you choose the option "from the date I sign this until my death". I have rejected a few too many documents under sad circumstances because the wrong box was ticked. Conditions such as "until I become incapacitated" make it impossible for the third party to determine when that date would be. Also creating a document stating "from the date of my incapacitation", insure that a trustworthy third party will pass on the document to all involved entities (i.e banks, benefit administrators) when that time arises.
C E Clark from North Texas on August 21, 2013:
This is such an important issue. I pinned it to my 'Health' board a while back and tonight I'm pinning it again, this time to my'Financial Issues' board. After all, health and financial issues are interlinked. Also sharing again with my followers who may not have gotten around to making a living will yet and this will be helpful to them.
Peggy Woods (author) from Houston, Texas on July 20, 2013:
That is a good feeling when living wills are in place. People caring for us when we get to that end stage of life need not struggle with making hard decisions. They can simply follow our wishes and rest easy knowing that was what we wanted for ourselves. You did a good thing!
Peggy Woods (author) from Houston, Texas on July 19, 2013:
Hi Au fait,
I agree that living wills are so very important! Thanks for helping to spread the word.
Peg Cole from North Dallas, Texas on July 19, 2013:
Very important information to share, Peggy. We faced this situation with my dear Auntie H when she could no longer swallow food. The hospital recommended putting in a feeding tube in her stomach. After a family conference with the closest living relatives we jointly agreed that she would not have wanted to be kept alive this way, unconscious with no quality of life or expectation of recovery at her advanced age. Following that experience, I prepared living wills for my Mother, her sister, myself and the hubby. At least now, our wishes are known.
C E Clark from North Texas on July 19, 2013:
This is such an important, informative, well written article that I had to come back to pin it to my 'Health' board. There are so many good reasons for people to have a living will. Going to share it again with my followers also.
Peggy Woods (author) from Houston, Texas on June 13, 2013:
Glad that you liked this. People should really think about making out living wills before it is too late. Thanks for the votes and shares.
justmesuzanne from Texas on June 11, 2013:
Excellent practical advice! Voted up, useful, tweeted, pinned and shared! :)
Peggy Woods (author) from Houston, Texas on June 10, 2013:
Hi Au fait,
I know that many people wish to avoid this subject but may live to regret it if living wills are not set up ahead of time. Thanks for the refresh and share. It is an important topic.
C E Clark from North Texas on May 31, 2013:
I think this is an important issue and that more people should be setting things up the way they want them in such a way as to be certain their wishes will be carried out. Sharing again.
Peggy Woods (author) from Houston, Texas on May 23, 2013:
Hi Indian Chef,
It always amazes me just how many people wish to avoid the subject of death and dying and for that reason they do not make out their wills and just as important...their living wills pertaining to how they wish to be treated and cared for at the end of life. Like it or not, we all should face reality and be prepared for the inevitable.
I was glad that I was able to stay with that cancer patient until the end although it was difficult. Appreciate your vote up + the share.
Indian Chef from New Delhi India on May 22, 2013:
Very touching story about a patient with cancer with metastasis all over the body. I have seen cancer patients and I know how painful cancer can be and people see death coming their way every day so can get depressed too. So i really appreciate you volunteered to look after him. voting up and sharing.
Peggy Woods (author) from Houston, Texas on March 26, 2013:
A living will is different from a regular will where you make decisions about where or with whom your children would live should you die or what happens to your property. It has more to do with what you wish doctors to do with regard to your treatment should you be terminal. Prolong life at any cost?...or make you as comfortable as humanely possible...but let you die a more natural and pain free death as possible. Both types of wills are equally important to have. Why leave anything to chance?
Peggy Woods (author) from Houston, Texas on March 24, 2013:
We are in agreement on the importance of having living wills. That is obviously in addition to the regular type of will. Both are important...but the living will has more impact to the last days of how a dying person is treated. Thanks for your comment, vote and share.
Mae Williams from USA on March 23, 2013:
We have a living will. It gives my kids peace of mind that if anything were to happen to us, they would live with a relative they like.
moonlake from America on March 23, 2013:
Great hub voted up and shared. I agree with you on living wills everyone should have one.
Peggy Woods (author) from Houston, Texas on December 30, 2012:
Hi Au fait,
Many people think of drawing up wills to pass on personal items or money to friends or family members but overlook the vitally important thing of also having a living will. That simple document can make a great deal of difference in how one is cared for in the last days...even hours...of life. It is a discussion one should also have with family members. Death is a natural part of life. My thought is why suffer needlessly at the end? Hospices now do great jobs on making sure patients are as pain free as humanly possible...but that is another entire subject tied to the end of life. Thanks for your votes and the share.
C E Clark from North Texas on December 29, 2012:
This is something everyone should read and then follow through on. How awful for that poor old man you described first!
Voted up, BAUI, and will share!
Peggy Woods (author) from Houston, Texas on July 12, 2012:
As a nurse you have probably seen more than your share of similar situations and then some. People need to be awakened to the fact that they can avoid situations like this and make their wishes known with a living will or advanced directive. Thanks for your comment, votes and the link to your wonderful hub.
Gail Sobotkin from South Carolina on July 12, 2012:
Excellent hub about the need for all adults to take control of their own destiny by executing living wills and advance care directives.
This article is a rare look at this topic from an experienced nurse's point of view. We take an oath to "do no harm" and yet some of the treatments that are ordered and carried out may conflict with that oath and cause ethical dilemmas, not to mention additional pain and suffering for the patient who has almost no chance of recovery.
No one should assume that their family will know what their wishes would be under situations similar to the above.
Hopefully, anyone reading this who doesn't already have a living will or advance care directive will realize that they should act now to make their wishes known and in writing.
I am going to add a link to this hub from my own hub about End of Life Care Issues.
Voted up useful, awesome and interesting.
Peggy Woods (author) from Houston, Texas on April 23, 2012:
That is so important to let your daughters know your wishes and if you have it in writing and they can show a doctor, even if it is not a legal document in India, at least everyone will know how you would wish for your final days or hours to end and perhaps your wishes will be fulfilled that way. Thanks for your comment.
neeleshkulkarni from new delhi on April 23, 2012:
never realized the importance of putting down choices for oneself.I did want to make a will but thought would only mention my property and how i wanted it divided between my two daughters.this is a new aspect and yes i will make one soon though i do not know if it is legal in India to do so but at least my kids will know what i want.
thanks for a nice bit of though provoking info.
Peggy Woods (author) from Houston, Texas on April 22, 2012:
Thanks for seeing the importance of having living wills in effect and thanks for your comment.
Ruchira from United States on April 22, 2012:
You have raised a very good and important question. Living will is important and I understand the consequences of it. Your examples are heart rendering and I pray that no one gets to go through this in their lifetime.
Voted up and sharing it across!
Peggy Woods (author) from Houston, Texas on April 05, 2012:
It is amazing to me that people put off doing such simple things, like having a living will in place, and taking chances with their future care. At any time due to accidents, sudden illness or other factors, our lives could change in an instant. Why leave decisions to others when we can make our wishes known today? Tomorrow could be too late! Nice that you have yours in place. Thanks for your comment.
Charlu from Florida on April 04, 2012:
Such sad stories but so valid an example when trying to explain the need for a living will. I have one and am pleased that as you said in your comment it is one of the first things they ask me when I'm in the ER or hospital. Voted up interesting useful Thank you for sharing.
Peggy Woods (author) from Houston, Texas on March 02, 2012:
Your hub on the same subject was excellent. Living wills and advanced directives are vitally important and more people should think of crossing that off of their "to do list" before it is too late. Thanks for your comment and the share.
L.L. Woodard from Oklahoma City on March 02, 2012:
Peggy W, you have so eloquently pointed out two good reasons for everyone to make their own choices through advance directives.
Voted up and SHARED.
Peggy Woods (author) from Houston, Texas on December 06, 2011:
It always amazes me that people do not take the time to make wills, much-less living wills. Both are vitally important! Even a hand written will counts! Some friends and I had to go to court to verify that we knew a friend of ours who died and only had a hand written will that had been discovered among her things where she lived...and that we recognized her hand-writing. While it was a bit more effort on our part to ensure that her final wishes be followed...it worked in the end.
Thanks for commenting on this important topic. Hopefully more people will get their affairs in order and make out their living wills along with their regular wills making mention of who inherits their belongings.
Peggy Woods (author) from Houston, Texas on November 18, 2011:
Hello Lost Heirs,
So very true. It is important to make one's wishes known prior to anything happening where one may no longer have a say in the outcome. Living wills are just extra insurance to have in place. Thanks for your comment.
Lost Heirs on November 18, 2011:
Living wills are important to ensure you have a say
Peggy Woods (author) from Houston, Texas on May 30, 2011:
Having a living will along with a regular one is one of the most important things you can do to prepare for the future. It is funny that people seem to put off doing things of such importance. Put it on the top of your priority list and I can assure you that you will rest easier when it is done. Just verbally telling people of your wishes does not carry the same weight.
billyaustindillon on May 30, 2011:
Sanguine advice - something I have not done and need too.
Peggy Woods (author) from Houston, Texas on January 18, 2011:
So sorry to hear of your experiences, Tony.
One of the first things people in hospitals ask for over here (to attach to the charts) is whether there is a living will. Makes decision making so much easier!
That is great that your wife knows of your wishes, but what if the two of you were in an accident together and she was unavailable to tell people of your wishes? Do your older kids also know of your wishes?
Having that piece of paper signed and notorized (the living will) just eases things. No one can accuse the ones that are left of purposely "pulling the plug" for inheritance reasons or any other such thing.
Hope you get that done. You will rest easier! Then make copies of it and give it to anyone who might be able to make sure that it gets enforced.
Thanks for the comment.
Tony McGregor from South Africa on January 17, 2011:
My brother-in-law was mortally injured in a gay-bashing incident some years ago and he was on life support for some days until his feet were going gangrenous and it was clear that he would not survive if taken off life support. My then wife and I discussed the issue and decided to ask the hospital to switch off the machines. They were very reluctant but eventually his doctor agreed. He died peacefull very soon afterwards. It was a very traumatic time for us.
Some years before my own brother died of lung cancer, just weeks after being put onto chemo which made him so sick.
Just a few weeks ago as you know my mother-in-law died of lung cancer. She went through months of hell caused by the chemo. I wonder about this. If the prognosis is poor, why put people through the additional trauma of chemo, why keep them "alive" hooked up to a machine? It makes no sense to me at all.
I don't have a "living will" yet, but my wife knows how I feel - if I should get cancer or any similar disease I don't want to be kept alive artificially or to go through the hell of chemo. Give me lots of morphine and let me die in peace!
Thanks for this wonderful Hub and I'm going to get that "living will" form signed now!
Love and peace
Peggy Woods (author) from Houston, Texas on July 23, 2009:
You have said it well. Having a living will is not only to protect oneself, but those you care about as well. Thanks for the thumbs up!
Shalini Kagal from India on July 23, 2009:
So vital Peggy - I'm so glad I came upon this hub. So many people seem to think that if they don't think about death, it will elude them. It makes so much sense to be practical. What I've also felt is, that with a living will, not only will your wishes be followed, it also relieves your loved ones of having to make decisions. It's a tough call for a child to take a decision to stop medication or turn off a life support system - so much easier when they are just following your instructions. Great hub - thumbs up!
Peggy Woods (author) from Houston, Texas on July 23, 2009:
Smart move, loveroflife!
More people should think of protecting themselves with living wills before it is too late. It is one of those adult responsibity things to do. Thanks for commenting.
loveroflife on July 22, 2009:
Good advice. I have had a living will for many years.
Peggy Woods (author) from Houston, Texas on March 23, 2009:
Hello mkhovu, Age has no bearing on when a living will might need to be enforced as you indicated.
Once people are placed on life support it is not always that easy to get it removed. Instead of hospital review boards having to make the hard decision or families having disagreements among themselves as to how or when to discontinue the medical intervention.......IF the person's will was known to everyone involved, it simply makes it so much easier a decision.
Thanks for your thoughtful comments and get busy........secure one for yourself and encourage others to do the same! Who knows what tomorrow might bring?
Connie on March 22, 2009:
This is a very useful hub Peggy. I must say it touched me. I'm in a medical field, below 40yrs and I must say I have been avoiding it just because I just didn't want to think about that day. This hub just reminds us all of the importance of preparing your will prior to disaster strike, as you say, there's no need to suffer the pain you can easily avoid.
Peggy Woods (author) from Houston, Texas on March 22, 2009:
I obviously agree Kulsum. I think that those of us who have been (or are) in the medical field see the necessity of this more than the average person simply because we see the horrible results. Hopefully more people will read this hub or similar bits of advice elsewhere and get this protection for themselves. This HAS to be done AHEAD of need. It is too late otherwise. And who can predict when the need might arise?
Dr Kulsum Mehmood from Nagpur, India on March 22, 2009:
Very important topic in this hub Peggy. I am glad you discussed this topic and opened the eyes of all the persons who will visit your hub here. It is very essential to make a living will. this is one topic we do ignore. And, this needs to be taken care of urgently. I definitely do NOT wish to be kept alive if my brain is dead and I am a vegetable due to some cause.