Episode Transcript
Interviewer: 如何和你65岁以上的父母谈论高级指令. That's next on The Scope.
Recording: 来自犹他大学医生和专家的医学新闻和研究，你可以用它来过更快乐、更健康的生活. You are listening to The Scope.
Interviewer: 这可能是一个艰难的对话，但它不一定需要. 这是你绝对应该和父母一起做的事情，尤其是如果他们超过65岁. That conversation is about advanced directives.
We're with Dr. Anna Beck from Huntsman Cancer Institute. Dr. 贝克，假设我不知道我父母是否有提前指示. I feel that they should because I know that it's a good idea. How do I bring that conversation up to them? 说“你们快要死了”感觉有点奇怪. When you do . . ." What's your advice there?
Dr. Anna Beck: Well, that's a very good question. 最近的数据显示大约50%的65岁以上的人因为计划外入院, so because they're sick for some reason that again, 50% of those patients need some help making their decision. 因此，代理人被要求参与决策过程.
所以我认为这对大发娱乐所有人都是一个很好的警告信号，大发娱乐的任何家庭成员都将达到65岁, 如果你不知道他们的代孕妈妈是谁或者他们还没有选择代孕妈妈, 他们有理由开始考虑整个过程.
Interviewer: So advanced directive just to be clear, 是他们失去了意识，无法做出决定，还是这在什么时候起作用?
Dr. Anna Beck: So it comes into play if they become impaired, 如果他们不能清晰地思考，或者不能积极参与决策. So for example, 假设你的父亲因为肺炎住进了医院，因此他呼吸急促, he's not able to speak clearly, or he's not able to understand. 也许他有听力障碍，也许他有一点痴呆，只是不能很好地思考这个过程. That's where a surrogate could step in and say, “这些都是合适的事情，这些都不是他想要做的事情."
Interviewer: 65岁以后，50%的人，这是很多，需要这种大发娱乐.
Dr. Anna Beck: Who get admitted to the hospital because they're ill. Yes, exactly.
Interviewer: 所以如果我跟父母提起这件事却发现他们不知道, 他们现在甚至不想谈这个话题, but I know it's a good idea that they should. How do you push forward?
Dr. Anna Beck: I would probably pick the process of saying, “我知道你不想成为一个负担，我也知道你不想谈论这件事的原因是因为它令人不愉快, 但要我在不知情的情况下搞清楚你想做什么对我来说压力很大. Can we at least talk about things that are important to you?"
Interviewer: Yeah.
Dr. Anna Beck: 我还建议给它设定一个时间限制，这样人们就不会觉得这是一个要持续几个小时的谈话.
Interviewer: Sure.
Dr. Anna Beck: And that's your initial expectation. It's like, "Oh, no! We're going to talk about that." If you say, "Can we just spend ten minutes? 告诉我一些重要的事情你想确保这些事不会发生在你身上或者我不想痛苦. I want you to always make sure that I'm comfortable. 我从来不想长时间死亡或者类似的事情或者只是说一些你想让我知道的事情, or tell me who your surrogate is.“也许他们已经选了一个代孕妈妈，而你不知道是谁.
Interviewer: Yeah.
Dr. Anna Beck: So again, kind of putting a time frame on it, “爸爸，让大发娱乐花十分钟时间来完成这个，这样我就不会有压力，我就会知道对你来说什么是重要的。."
Interviewer: 我喜欢它的框架，更大的画面，而不是如果你在维持生命. Do you want to be on it or not? 更重要的是，当你的生命结束时，什么对你来说是重要的? I like that.
Dr. Anna Beck: Exactly. 这是你提出的另一个观点很多时候人们不能说, "Well, yeah, I want to be on life support, or I don't want to be life support, or I want to get fluids, or I don't want to get fluids."
Interviewer: Because that's what those forms look like.
Dr. Anna Beck: Yes, right.
Interviewer: Those are the questions those forms ask.
Dr. Anna Beck: Yeah, and I have a problem with that on the forms as well too. 所以我认为，随着人们年龄的增长，身体越来越虚弱，你应该和医生谈谈哪些事情可能是潜在的选择，哪些事情可能发生在你身上，这很重要.
但我认为如果你能从总体目标的角度来表述的话, like playing with grandkids, being able to interact with my family, being able to toilet myself, 试图大发娱乐他们弄清楚什么是他们想要保存的重要的东西，这样他们的生命才有价值. 如果没有，那就不要延长我的死亡时间，如果你愿意的话.
Interviewer: 是的，如果我想大发娱乐我的父母完成这个过程，我的下一步是什么? Do I need to go to a lawyer? Are there forms online? Could I contact their doctor? Would they have something?
Dr. Anna Beck: Yes.
Interviewer: Yes, yes, and yes.
Dr. Anna Beck: Yes, the answer is yes to all of those. 你可以在网上下载一些表格. 和他们的医生预约也是一个好主意因为他们的医生也需要了解他们的愿望.
Interviewer: Okay.
Dr. Anna Beck: But it's really a triad. It's the patient, it's the surrogate, and the physician. 所有这三个人都需要在同一页上，需要定期更新文件，这样每个人都知道每个人的愿望是什么.
Interviewer: All right. 关于和你年迈的父母谈论临终指示有什么最后的想法吗?
Dr. Anna Beck: 我想你可能会惊讶于这种谈话是多么的轻松，因为他们通常都在思考这件事，有时只是能够分享他们的想法，他们会感觉更好. 我鼓励你们在和他们交谈之后做一次内心的检查，也许也问问他们. Was that difficult? Was that hard for you to talk about? And I think you may be surprised at the answer.
Recording: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.