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Care at the End of Life - Important Decisions
Many important decisions can be made about the care you want to receive at the end of life while you are active and able to communicate your wishes. By making arrangements in advance, valuable time can be used to spend time with loved ones.
Communicating your health care decisions
By completing an advance directive, which documents your health care preferences, you can help ensure your wishes will be respected if you become unable to communicate for yourself.
An advance directive can always be changed as your personal needs and goals change. Advance directives include:
- A living will, which is a legal document that expresses your wishes for medical care if you become unable to speak or make decisions for yourself. It allows you to keep control over your medical treatment decisions at the end of life. Check the laws governing living wills in your state. When considering some of the more difficult end-of-life decisions, it may help to think about what kinds of medical procedures you would or would not want.
- A medical power of attorney (or durable power of attorney for health care), which allows you to legally appoint a health care agent (also called a health care proxy) to make medical treatment decisions for you, not only at the end of your life but any time you are unable to speak for yourself. You can and should make decisions about your medical treatment for as long as you are able to make and communicate them. But when this is not possible, your health care agent can use both the written information in your living will as well as what he or she knows about you personally to make decisions about your medical treatment.
For more information on choosing a health care agent and writing an advance directive, see:
Organ donation
Organ donation is another important decision to consider at the end of life. Many people need organ transplants because of medical conditions such as kidney failure, cornea disease, or heart failure. After your death, you may be able to donate certain organs depending on their condition. Talk to your doctor about whether your illness allows you to be an organ donor.
If you choose to donate, your organs may be distributed to one or more people, based on blood and tissue type, the severity of the recipient's medical condition, how long the recipient has been waiting, and geographical location.
If you are interested in donating, you can indicate this on an organ donor card, a witnessed document that states your desire to donate your organs. On this card, you can specify which organs you wish to donate, or you can choose to donate any organ that is needed at the time of your death. Many states allow people to designate on their driver's licenses their wishes regarding organ donation.
WebMD Medical Reference from Healthwise
Care at the End of Life Topics
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
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