ANDProjectThe A.N.D Project

A.N.D. means “Allow Natural Death”. The term was introduced in 2000 by Rev. Chuck Meyer in response to families’ negative experiences at the end-of-life: such as seniors, who were actively dying, receiving CPR (Cardio-Pulmonary Resuscitation), which families felt was inappropriate and did not provide death with dignity.

A.N.D. is meant to allow for a “natural” death, ensuring that only comfort measures are provided at the end-of-life, and to prevent unintentional pain/suffering. It also permits the withdrawal of nutrition and hydration, so that we don’t interfere in the dying process.

Studies have verified that those with incurable or life-limiting diseases (diseases which would normally cause a person to die – such as Alzheimer’s Dementia, end-stage heart or lung or kidney disease, certain cancers, AIDS) want honest information and to be involved in decisions about their treatments; and, to not have the dying process prolonged.

Unfortunately, the public and healthcare professionals often believe several myths about end-of-life care, such as the ability of seniors to recover from CPR. This, in turn, leads frequently to not having an Advance Directive (Living Will) which could help prevent non-beneficial treatments such as CPR.

Palliative Care programs across the United States are introducing the term A.N.D. as a replacement for DNR (Do Not Resuscitate), a negative and confusing term to everyone, and encouraging people to complete an appropriate Advance Directive.

In response to these national trends, Hospice of the Shoals and Eliza Coffee Memorial Hospital have initiated an effort to improve end-of-life care (EOLC) for people in Lauderdale County, during 2007-08.

Hospice of the Shoals will be responsible for:

  • Educating seniors in Lauderdale County about the AND term, the myths surrounding EOLC, and Advance Directives. (via presentations to seniors groups, churches, service clubs, etc.)
  • Encouraging seniors to complete an Advance Directive and write into it “AND /DNR” or “No CPR”, if appropriate for them.

ECM Hospital will be responsible for:

  • Storing the Advance Directives electronically as soon as that format becomes available.
    Educating physicians and healthcare staff about the AND term.
  • Piloting an intensive communication & education project for patients and families in the ICU, focusing on goals and the most appropriate care to reach those goals for that family.

At the end of one year, our goals are: that 50% of all seniors in Lauderdale County will have an Advance Directive, which includes the AND term if applicable for them; to have these Advance Directives electronically filed, so that they would be more readily available to everyone; and, to have improved quality of care in the ICU resulting in improved patient/family and staff satisfaction.

If you would like a presentation to your group, please call Hospice of the Shoals at 767-6699.