This Is An Area Where The myHR Might Help But Only With A Lot Of Work.

This appeared last week and got me thinking:

'Anything to save them': Medics reveal human cost of our denial

Emma Young
Published: February 15 2018 - 11:48AM
One day in an Australian hospital ward, two men were dying. Both lay in rooms off the same corridor. But their stories unfolded very differently.
The first was 95 years old. He had end-stage diabetes and heart disease. He had collapsed during a heart attack and was taken to hospital unconscious. There was no advanced care directive to indicate how he felt about treatments. His daughter arrived, shocked and distraught, and insisted on all possible treatment.
Doctors did CPR for 45 minutes, "jumping on his chest," breaking his ribs and sternum – as was standard for resuscitation, said Merran Cooper, the junior doctor who was on the wards that day.
"We could not bring him back to life," she said. "After a certain number of times the head physician had to call it – there was no oxygen left in his brain. By that time there were nurses crying."
Across the corridor lay another man, also 95, also very sick. His daughter, a nurse, and his wife were both with him. They had had family conversations about the end of his life well in advance. They decided this was enough, that they would make him comfortable and let him die.
"They had a room in which they could be together, and each had time alone with him, a little vigil," Dr Cooper said. "He passed away peacefully."
Dr Cooper is no stranger to the mystery and unfairness of death.
When she was 23, her husband Mark was diagnosed with leukaemia after they had been married six months. After 11 months of intensive treatment he was able to go home, only for the family to hear his bone marrow transplant had failed. Yet nobody said the "D-word" until a family friend visited.
"He said, 'Mark, you are going to die, whether it is now or in a few weeks or in a few years. Face it now. Speak to your parents, speak to Merryn. Stay hopeful but face it now.' It changed the last three weeks of Mark's life. He said goodbye to people," Dr Cooper said.
Mark was hospitalised on his last morning of life but medical intervention was minimal. He had no intravenous drugs, no tube down his throat. His wife and family agreed that this was it. His wife was able to lie on the bed beside him. Among his last words were 'Mezzy, you are so soothing'.
It was after this experience, and the death of her best friend at 45 of a neurological disease, that Dr Cooper decided to retrain in medicine. She finally gained her qualifications at age 56. Last year was her first as a junior medical officer. Since then she has seen many people whose last moments look a lot like the first father's.

Lots more here:

http://www.watoday.com.au/wa-news/anything-to-save-them-medics-reveal-human-cost-of-our-denial-20180214-h0w2jy.html

The idea of using the myHR as a repository of Advanced Care Directives (ACD) is hardly new but the issue is how to make sure they are both available, accessible and even more important it is really certain they reflect the patient's wishes so they will actually be acted upon if the time comes.

What this is going to mean is that those who want to have an ACD stored make sure their nearest and dearest all know there is a ACD available and they know what it says so there is no confusion or disagreement about what should be done.

Making the ACD's accessible to those who need them is a soluble technical problem. Building the social understanding and infrastructure in the community is a problem of an entirely different dimension that needs to be fully addressed in parallel before use of the myHR in this role makes any sense at all.

What do you think on all this?

David.