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While James McReynolds, M.D., discussed many aspects of end-of- life care during his recent presentation at the Great Bend Senior Center, one theme was evident.

“We should be thinking about end-of- life care now instead of waiting for catastrophe to strike,” Dr. McReynolds emphasized. “Health care at the end of life involves reflection and forethought so that you and your family are better prepared.”

Dr. McReynolds’ practice is at Great Bend Internists, which is on the second floor at St. Rose Health Center. He welcomes talking with his patients about end-of-life care; he is accepting new patients.

“We know this topic is uncomfortable,” he said. “And I am not suggesting you dwell on it. But it is important to plan ahead and prepare for difficult decisions. Planning means less anger, fear and regret.”

Dr. McReynolds outlined three options for consideration. One is a Do Not Resuscitate (DNR) order.

“If you don’t want CPR or to be put on a breathing machine, we need to know. Your DNR order should be given to your doctors and the hospital you use.”

Another suggestion is a living will that can direct health care without a surrogate.

“Maybe you want chest compressions but not a ventilator. Or maybe you are okay with IV fluids but not the insertion of a breathing tube,” he outlined. “You can be specific.”

A third recommendation is a Durable Power of Attorney for Health Care Decisions. This is separate from other powers of attorney that deal with topics
such as finances.

“You should find someone you really trust and also consider a back-up surrogate,” Dr. McReynolds said. “Some family members may know what you want, but others may not. The surrogate is authorized to make decisions when you, the patient, are no longer able to make your own decisions.”

Dr. McReynolds emphasized that any of these three options can be easily revoked for those who change their minds.

“Another factor to consider is that when health declines, priorities and perceptions may change,” Dr. McReynolds noted. “You may think one way today but think differently when health issues are serious.

“Some people want to live a long time, no matter what. Others are more concerned with quality of life and want to maximize their time, even if it means they may die sooner,” he continued. “Many people don’t want to live if they can’t take care of themselves and enjoy their regular activities. There are no right and wrong answers in these situations.”

Because of the uncertainties of life, a stroke or other sudden illness, or a life-threatening accident can occur without notice.

“Such situations can happen to any of us at anytime,” Dr. McReynolds summarized. “Please take time to plan when there is not a physical and emotional crisis.”