Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Advance directives are designed to outline a person's wishes and preferences in regard to medical treatments and interventions.
When a patient is incapable of making his/her own medical decisions, a health-care proxy can act on the patient's behalf to make decisions consistent with and based on the patient's stated will.
Advance directive policies may different from one state to another.
Drafting a proper advance directive form may require assistance from your personal physician and an attorney.
Advance directives are important documents that should be included with each individual's personal medical records.
Introduction to advance medical directives
Advance directives: The term "advance directives"
refers to treatment preferences and the designation of a surrogate decision-maker in the event that a person should become unable to make medical decisions
on her or his own behalf.
Advance directives generally fall into three categories: living
will, power of attorney, and health-care proxy.
Living will: This is a written document that specifies what types of
medical treatment are desired should the individual become incapacitated. A
living will can be general or very specific. The most common statement in a
living will is to the effect that
if I suffer an incurable, irreversible illness, disease, or
condition and my attending physician determines that my condition is
terminal, I direct that life-sustaining measures that would serve
only to prolong my dying be withheld or discontinued.
More specific living wills may include information regarding an individual's
desire for such services such as
analgesia (pain
relief),
antibiotics,
artificial (intravenous or IV) hydration,
artificial feeding (feeding tube),
CPR (cardiopulmonary
resuscitation),
life-support equipment including ventilators (breathing machines),
do not resuscitate (DNR).
Health-care proxy: This is a legal document in which an
individual designates another person to make health-care decisions if
he or she is rendered incapable of making their wishes known. The
health-care proxy has, in essence, the same rights to request or
refuse treatment that the individual would have if capable of making
and communicating decisions.
Durable power of attorney (DPOA): Through this type of advance
directive, an individual executes legal documents that provide the
power of attorney to others in the case of an incapacitating medical
condition. The durable power of attorney allows an individual to
make bank transactions, sign social security checks, apply for
disability, or simply write checks to pay the utility bill while an
individual is medically incapacitated.
DPOA can also specifically designate different individuals to act on a person's behalf for specific affairs. For example, one person can be designated the DPOA of health-care or medical power of attorney, similar to the
health-care proxy, while another individual can be made the legal DPOA.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Dementia is a significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. There are different criteria classification schemes for dementias such as cortical, subcortical, progressive, primary, and secondary dementias. Other conditions and medication reactions can also cause dementia. Dementia is diagnosed based on a certain set of criteria. Treatment for dementia is generally focused on the symptoms of the disease.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Alzheimer's disease is a common cause of dementia. Symptoms and warning signs of Alzheimer's disease include memory loss, difficulty performing familiar tasks, disorientation to time and place, misplacing things, and more. The biggest risk factor for Alzheimer's disease is increased age. Treatment for Alzheimer's is often targeted toward decreasing the symptoms and progression of the disease.
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
Most often, caregivers take care of other adults who are ill or disabled. Less often, caregivers are grandparents raising their grandchildren. The majority of caregivers are middle-aged women. Caregiving can be very stressful, so it's important to recognize when it's putting to much strain on you and to take steps to prevent/relieve stress.
impairment in another area of thinking such as the ability to organize thoughts and reason, the ability to use language, or the ability to see accurately the visual world (not because of eye disease), and
these impairments are severe
enough to cause a decline in the patient's usual level of functioning.
Although
some kinds of memory loss are normal parts of aging, the changes due to aging
are not severe enough to interfere with the level of function. Many different
diseases can cause dementia, but Alzheimer's disease is by far the most common
cause for dementia in the United States and in most countries in the world.
What is Alzheimer's disease?
Alzheimer's disease (AD) is a slowly progressive disease of the brain that is
characterized by impairment of memory and eventually by dist...
Healthy Living Tips
Health News Feed
This site complies with the