4 - 5 - Scenario - Advanced Directive for Pregnancy (5 minutes), Health Literacy and Communication for Health ...
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[MUSIC]>> Congratulations.Your first pregnancy is very exciting.>> Yeah.Wow, we are really pregnant.>> Uh-huh.For real, pregnant.[LAUGH]>> Yes, you are.There's a lot foryou to think about right now.But you should remember.Even in a healthy pregnancy ina younger woman, there are many,many things that can go wrong.Due to your advanced age.>> She's 36.>> Exactly, and with your heart condition,you are at higher risk of complications,so there are some thingsyou should consider.>> What kind of things?>> Is everything okay?>> Yes, for now things are fine.However, both of these conditionsare potentially life threatening.I recommend an advance directive anda durable power of attorney.A C section is a major surgerywith many associated risks andpossible complications, even in a healthypregnancy, without your risk factors.A colleague of mine losta woman just last year.Excessive bleeding andnothing they could do to stop it.It's unusual but it happens.So it really is important foryou to have your ducks in a row.I recommend an advanced directive orDPA, maybe a DNR too.Here's some brochures with someexamples for you to look over.Make sure to schedule your nextappointment on your way out.Again, congratulations.[SOUND] Congratulations!Your first pregnancy isalways very exciting.And I realize,sometimes a bit frightening.>> Yeah, it is!>> And it involves a lot of planning.>> But we have nine months, right?>> Right, ideally.[LAUGH] Some of the things thatwe are going to talk abouttoday might seem a little scary.But they are all part of the planning, andare only ever used ina very few circumstances.Because you are over 35, and because youhave a heart condition, you may want toconsider an advanced directive,as well as a durable power of attorney.>> During the exam,you said everything was fine.>> And it is.I recommend these stepsto all my patients.Pregnancy has a lot of unknowns.And it's better to discuss thesesituations when everything isgoing well andwhen everyone can think clearly.>> What are we supposed tobe thinking about, again?>> An advanced directive is a documentthat outlines what you want doctors andmedical staff to do ifyour life is in danger.You can decide whether you would wanteverything and anything medicallypossible to be done to keep you alive orif you would only want certain things.Writing it down makes it easier forus to know what you wantus to do in an emergency.>> Well, I don't know what I'd want.>> I don't think she shouldbe thinking about that stuff.That can't be good for her.>> It is a lot to think about.But better to do it now ratherthan have decisions made foryou if it becomes necessary.A durable power of attorney issomething else you should consider.>> We're not exactly married.>> No.>> A durable power of attorney allows theperson of your choice to make healthcaredecisions for you in the event that youare unable to make them for yourself.A C-section may seem pretty routine,but it is still a major surgery.>> Hm.Do we need to hire a lawyer?>> Not necessarily.I can give you some information totake home with you and read over.Along with some examplesof an advanced directive,a durable power of attorney anda do not resuscitate order.You can take your time to look themover and, when you come in foryour next visit,I can answer any questions you might have.How does that sound?>> Scary but helpful.>> Everything is fine andhopefully it will stay that way.But just in case,it is important to be informed.Do you have anymore questions.>> Not today, but when I come back.Thank you.[MUSIC]
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