To upload your sorting decisions for your Natural Dying-Living Will |
After you finish sorting the 48 illustrated cards, you can enter your decisions here
What is the purpose of completing this form?
To upload a permanent record of your decisions regarding whether you want "Treat & Feed" or you want "Natural Dying" for each of the 48 cards/items you considered. You can also write down additional directions or instructions.
Caring Advocates will use your "data" to create your personalized Natural Dying-Living Will. Your proxy/agent and your future physician can use this document to decide WHEN it is time for Natural Dying.
If you sorted "real" jumbo-sized flash cards, you probably have three stacks of cards. You can complete your WALLET CARD and refer to it as you upload your data since the table looks the same.
If you have made your decisions using "virtual" cards then you or perhaps the person who interviewed you may have written your choices on a "My Decisions Table." (Examples of "virtual" sorting include: using an e-book version, or viewing a PowerPoint presentation at a workshop or seminar, or on a laptop, digital photo-frame, or tablet. You may also have sorted at a distance using the APP, "InterviewByInternet.com,"
Use these Initials to memorialize your decisions:
TF = "Treat & Feed," which means "Try to keep me alive. This item is NOT for Natural Dying."
NDE = "Natural Dying, Enough" given the amount of suffering expected from this item by itself.
DL = “Decide Later.” My proxy/agent has 100% “leeway” to decide contemporaneously, if conditions I placed in this category will become NDE or remain the default of TF based on whether the condition causes… severe suffering? Or moderate suffering but TF provides little or no benefit? Or moderate suffering but several current DL conditions combine to make suffering severe?
(For card/items that are NOT important to you or are not relevant, skip them by leaving the choice blank.)
When you are done, the table on this computer page in SurveyMonkey should look just like either your wallet card or the "My Decisions Table."
Instructions on how to enter your data (if needed):
Suppose the first card in the "YES: DL along with other items" stack has the number "4.3".
Go down the Column on the extreme left that begins with "1." (Note the period is AFTER the "1".)
Stop when you reach Row “4.”
Now move to the right until you are under the Column that has the name above of “.3”.
This is Box "4.3".
Click any where on this box and select “Yes (DL with other items)” from the drop down list.
You should now see a "Yes (DL with other items)" in box “4.3”
When you have entered all your choices, hold your wallet card or "My Decisions Table" near your computer to make sure the numbers in the two tables are the same.
To upload a permanent record of your decisions regarding whether you want "Treat & Feed" or you want "Natural Dying" for each of the 48 cards/items you considered. You can also write down additional directions or instructions.
Caring Advocates will use your "data" to create your personalized Natural Dying-Living Will. Your proxy/agent and your future physician can use this document to decide WHEN it is time for Natural Dying.
If you sorted "real" jumbo-sized flash cards, you probably have three stacks of cards. You can complete your WALLET CARD and refer to it as you upload your data since the table looks the same.
If you have made your decisions using "virtual" cards then you or perhaps the person who interviewed you may have written your choices on a "My Decisions Table." (Examples of "virtual" sorting include: using an e-book version, or viewing a PowerPoint presentation at a workshop or seminar, or on a laptop, digital photo-frame, or tablet. You may also have sorted at a distance using the APP, "InterviewByInternet.com,"
Use these Initials to memorialize your decisions:
TF = "Treat & Feed," which means "Try to keep me alive. This item is NOT for Natural Dying."
NDE = "Natural Dying, Enough" given the amount of suffering expected from this item by itself.
DL = “Decide Later.” My proxy/agent has 100% “leeway” to decide contemporaneously, if conditions I placed in this category will become NDE or remain the default of TF based on whether the condition causes… severe suffering? Or moderate suffering but TF provides little or no benefit? Or moderate suffering but several current DL conditions combine to make suffering severe?
(For card/items that are NOT important to you or are not relevant, skip them by leaving the choice blank.)
When you are done, the table on this computer page in SurveyMonkey should look just like either your wallet card or the "My Decisions Table."
Instructions on how to enter your data (if needed):
Suppose the first card in the "YES: DL along with other items" stack has the number "4.3".
Go down the Column on the extreme left that begins with "1." (Note the period is AFTER the "1".)
Stop when you reach Row “4.”
Now move to the right until you are under the Column that has the name above of “.3”.
This is Box "4.3".
Click any where on this box and select “Yes (DL with other items)” from the drop down list.
You should now see a "Yes (DL with other items)" in box “4.3”
When you have entered all your choices, hold your wallet card or "My Decisions Table" near your computer to make sure the numbers in the two tables are the same.