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Viable painless endgame plans?


1FinickyOne

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Is there a way to better the odds of a peaceful passing along? 

 

I know we cannot accurately predict our own cause or time of death, but... 

 

I was in ICU a week or so ago and an older man was moaning loud and uncomfortable. When I returned a week later, he was still there, condition unchanged. I doubt he was on any road to recovery. I would not want to end my life with a month or more of discomfort. I do think I could mentally prepare myself for a peaceable progression to "whatever land"?? And would love to go out in that manner...

 

Is this achievable? I understand it might be a matter of cutting life a bit shorter. Any ideas? Instructions for pain meds? My parents had a relatively peaceful exit assisted by hospice care in USA, but think that is not available here...

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11 minutes ago, nikmar said:

Its a bit morbid but I have  thought about this myself. 

But, what if there is a God and he aint pleased that you saw fit to do his job. 

Then he is not worth worshiping if you thinks its ok to let people die in pain. 

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1 hour ago, nikmar said:

Its a bit morbid but I have  thought about this myself. 

But, what if there is a God and he aint pleased that you saw fit to do his job. 

Or what if he was appreciative of my helping out a little... the religious aspect will be an issue for some - I just have this image of lying in a bed in a field with a soft breeze, pleasant music and a nice comforter... I would say somewhere in my mid 80s, maybe I would be healthy enough but what % of people past 90 are really enjoying life? 

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1. Execute a Living Will, they are now recognized under Thai law. Needs to be in Thai so best to have a lawyer do it.

 

2. Make sure whomever would be likely to make decisions if you are incapacitated knows about this document, has a copy, and understands your wishes and is prepared to advocate for them. This is critical.

 

3. If you develop a terminal illness get under the care if a palliative care speciailist as your primary doctor.

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7 minutes ago, poanoi said:

....

and for your info: the topic is about suicide, how to do it painlessly

The thread is about how to avoid an unnecessarily prolonged death and suffering. Not the same thing. 

 

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Saw my dad pass away in circumstances that were awful. If it were a dog, we'd be accused of cruelty.  Grandad had the same terrible end game. He tried to end it on whisky and pills, and the silly so and so's brought him round to face a terrible ending.  Mum is slowly becoming senile and will no doubt end up scrunched up like a dead mouse.

 

Nothing good to say about health care regarding these points (torture for us relatives too) though it is a societal issue more than a medical one.  We need to be brave enough to deal with this issue which is becoming increasingly difficult.

 

 

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On 1/25/2018 at 9:13 PM, Sheryl said:

1. Execute a Living Will, they are now recognized under Thai law. Needs to be in Thai so best to have a lawyer do it.

 

2. Make sure whomever would be likely to make decisions if you are incapacitated knows about this document, has a copy, and understands your wishes and is prepared to advocate for them. This is critical.

 

3. If you develop a terminal illness get under the care if a palliative care speciailist as your primary doctor.

Is a Living Will the same as a DNR here in Thailand ?

 

I drew up a DNR in 2012 after my first TIA and breathing complications.

I also have multiple drug allergies including antibiotics.

I ALWAYS have my DNR and medical details with me when ever, where ever I go out, a copy is also on display at my house.   The hospitals I have attended also have the same documents.

I discussed the documents with family / close friends / doctors before drawing them up.

Since June of last year I have ( rather my close friend has ) presented the documents twice on my behalf and, both hospitals have produced their copies too for me to confirm.   

The difficulties may be if one is unconscious at the time of hospital admittance.  Also I get a feeling that a DNR may only be accepted here if one is being attended in hospital by their own ( normal ) doctor.

 

A DNR may not make your passing easier but it will help make it easier for those left behind.

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A Living Will would usually contain provisions regarding resucitation but would also often cover matters other than resucitation.

 

For example mine says:

 

"I do not want my life to be prolonged with life sustaining treatment if (a) I am permanently unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness; (b) I have an incurable or irreversible condition which is terminal, or (c) I have irreversible brain damage and will never regain the ability to make decisions and express my wishes....

 

Life sustaining treatment shall include, without limitation, intubation, use of ventilator, B-PAP or other breathing devices, tube feeding or parenteral nutrition, dialysis or any other measure that would keep me alive but would not cure me....

 

In circumstances such as those mentioned above, I shall not be subjected to any medical intervention or life sustaining treatment aimed at prolonging my life. I hereby direct that all such orders be placed in my medical record.


Any distressing symptoms occurring in the aforementioned circumstances shall be fully and aggressively controlled by appropriate palliative care, ordinary nursing care, analgesic or other treatments, even though some of these treatments may have secondary effect of shortening my life.


Giving intensive care to me is to be allowed only on the condition that reliable reasons exist for the possibility that such treatment will have a better result than merely short prolongation of life. In the event that a treatment with prospect of recovery has been started but proves to be futile, it has to be discontinued immediately."

 

It then goes on to appoint a health care proxy. That part is very important.

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19 minutes ago, Sheryl said:

A Living Will would usually contain provisions regarding resucitation but would also often cover matters other than resucitation.

 

For example mine says:

 

"I do not want my life to be prolonged with life sustaining treatment if (a) I am permanently unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness; (b) I have an incurable or irreversible condition which is terminal, or (c) I have irreversible brain damage and will never regain the ability to make decisions and express my wishes....

 

Life sustaining treatment shall include, without limitation, intubation, use of ventilator, B-PAP or other breathing devices, tube feeding or parenteral nutrition, dialysis or any other measure that would keep me alive but would not cure me....

 

In circumstances such as those mentioned above, I shall not be subjected to any medical intervention or life sustaining treatment aimed at prolonging my life. I hereby direct that all such orders be placed in my medical record.


Any distressing symptoms occurring in the aforementioned circumstances shall be fully and aggressively controlled by appropriate palliative care, ordinary nursing care, analgesic or other treatments, even though some of these treatments may have secondary effect of shortening my life.


Giving intensive care to me is to be allowed only on the condition that reliable reasons exist for the possibility that such treatment will have a better result than merely short prolongation of life. In the event that a treatment with prospect of recovery has been started but proves to be futile, it has to be discontinued immediately."

 

It then goes on to appoint a health care proxy. That part is very important.

Thank you for the above Sheryl.   Obviously a lot of thought and knowledge has gone in to your document.

I have included most if not all of your points in my own DNR although in a much more basic way.

The contents of your text is very understandable, even to me and, I have been able to confirm with my doctors that they understand my own directive.     Those who may be with me at the time also understand clearly my requests.

 

Dialysis ( refusal ) is important to mention, something I had to argue with the doctors who attended me last June.

 

In 2012 before I had made out a DNR I had to be conscious at the time of my request for "alternative" treatment after antibiotics failed.   The alternative treatment worked.    Alternative treatments are now written in to my DNR.   This obviously not for everyone but my own choice has been proved right on two further occasions. 

 

The important thing is to ask yourself "Do I understand what I have requested ?" 

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