Glossary for Living Wills and End of Life Concerns

When it comes to severe medical situations and end of life decisions, there's a lot of jargon floating around. A big part of what you need to know is buried in the vocabulary. You may not be writing or communicating what you hope. Cruise through these explanations to help yourself along.

Any determination of what's legal is made by your state. Check with your lawyer to make sure you've got it right for where you live.

Advance Directive: Legal document in which you tell (direct) others in your health care preferences when you are too sick to say so yourself. This is about what you want and prevents others from making decisions, contrary to your wishes, for you. You can revoke it at any time being sure to notify all to whom you have given it--doctors, hospitals, and so on. Caring Connections has state-specific advance directive forms.

Assisted Living: Assisted Living provides help to those in a minimal care facility so that they may continue living on their own terms. Assistance may be with personal care, housekeeping, meals, medications or other care.

Brain damage: Damage to the brain cells from a variety of causes such as stroke, trauma or disease. Mildly slurred speech following a stroke, with no other impairment, could be considered brain damage. Apparently irreversible coma may be considered it, as well. Wikipedia has a detailed entry on brain damage. There is a lot of leeway that needs to be considered before you use this term in an Advance Directive or Living Will.

Do Not Resuscitate (DNR): A DNR order prevents medical professionals from "restarting" your heart following a cardiac arrest (your heart stops beating.) One that works in the hospital may not suffice outside the hospital, for instance, in regards to Emergency Medical Personnel. There are, however, DNRs available for that situation should you desire one.

Durable Power of Attorney: A legal document that gives your designated person the right to do business on your behalf. It does not confer decision-making power. However, abuse of this power has often occurred when that person does business in your name without your knowledge. Be very circumspect in choosing someone you absolutely trust. It is durable because it continues in effect when you are unable to make decisions on your own.

Extraordinary Measures: This describes medical treatments that go beyond customary in preserving and prolonging life. For some, administering oxygen is considered life support within the realm of extraordinary measures. For others, administering oxygen is considered palliative treatment providing ease of symptoms to the dying patient. Be clear on what "extraordinary measures" means to you.

Guardianship: A legal relationship in which one person takes responsibility for decisions relating to another's care--medical, financial and legal. It is empowered by a judge who determines that you are no longer able to make decisions on your own. Like the parent-child relationship, it is open to abuse or peace of mind.

Healthcare Proxy: Also called a Medical Power of Attorney, the Healthcare Proxy is one who is empowered to approve medical decisions on behalf of another. Like the Durable Power of Attorney, it does not confer the right to make decisions. It allows the holder to legally sign in accordance with the wishes of the sick individual.  It is also durable, continuing when you are too sick to sign for yourself and is subject to the same cautions.

Home Health: A service that comes into the home to help with personal care and household care. While limited services, they may allow you or one you love to remain in their own home for quite a while without other services.

Hopeless: The condition in illness in which recovery is not expected. Keep in mind that all definitions of hopeless are not the same. Being paraplegic may be hopeless, but that's not the same as comatose and not expected to regain consciousness. Legal descriptions can be tricky.

Impaired: Right along with hopeless, impaired may be interpreted very differently.

Informed Consent: Your consent to a medical treatment after being told of ALL the possible outcomes, good and bad.

Irreversible: The conditions discussed will only become progressively worse. To others, it may be that the condition will continue. Once again, this is open to interpretation.

Life Prolonging: Treatment given to extend life, whether months, weeks or minutes, without necessarily regarding the quality of that living.

Long Term Care: Long-term care implies assistance with the details of living whether in the home, assisted living facility or nursing home. For a free evaluation of options, check out Long Term Care Living.com's guide.

Loss of Dignity: This is up for grabs. To some, it means to be treated with respect, especially in regards to one's wishes for personal and medical care. To others, it means that they believe your condition of life is "undignified" and without worth of continuance. It really depends on philosophy of life and who is making the call. It's not a good choice of words in a legal document.

Medical Power of Attorney: Also, Healthcare Proxy. This gives power to another to legally sign for your medical treatment, in accordance with your wishes, when you are unable to do so for yourself.

Nursing Home: Living facility in which most personal care needs are provided including bathing, dressing, medications, assistance with eating and 24 hour supervision.

Palliative Care: Palliative treatment does not treat a disease with the intention of curing it. It is treatment for symptoms to ease distress and alleviate pain. This is a mainstay of Hospice care.