Conversations about your wishes for the end of your life are some of the most important ones you will ever have, but they are also likely to be some of the most difficult. As a respiratory therapist, I have seen too many times the confusion and misunderstanding that can come when no one knows how you want to leave this world. Should we continue using the ventilator to keep you breathing? Should your heart stop, should we do chest compressions? Should we feed you through a tube if you cannot eat? When you are not able to make these decisions for yourself, health care professionals must assume you want everything possible done, whether you want that or not.
One way to avoid that is to have open conversations with your caregivers and family members. Those are the first people health care professionals seek out when trying to provide the best care for you. It is never too early to have these conversations because one never knows what can happen (especially in the age of COVID). Even as a healthy 45-year-old, I have had regular conversations with my wife and kids about what I do and do not want in case of a severe injury or illness. That way, everyone is on the same page, and no one has to make such a heavy decision on their own.
Mutual support and open communication are critical. I have also seen plenty of situations where some family members are sure care should go along one path, while others are sure it should go another. In these situations, we also have the duty to err on the side of caution and do everything possible to keep your body alive. If everyone is aware of your wishes, that can help prevent that. However, you may also want to think about choosing a specific person who has the legal power to make decisions on your behalf. This is known as giving someone durable power of attorney (DPOA) for health care. It is also sometimes called making someone your patient advocate or health care proxy. By using a DPOA, you can spell out exactly which procedures you are willing to have to prolong your life and which ones you are not. You are also able to specify who can make decisions in situations that are not exactly described in the DPOA order. You can pick one or two people, and their decisions are legally binding (as long as they are consistent with any requirements or instructions you add to the DPOA). This kind of document is especially important in a state like mine that does not recognize living wills and similar “advanced directive” orders. You are also free to change your mind at any point and change who your advocate is or what your instructions are if you go through the proper legal process.
These are difficult conversations to have at any point in your life. They should be handled with a great deal of care because as a parent, a child, a sibling, or a friend, we do not want to consider the possibility of our loved ones not being around. Emotions can run high, and it is important to make sure everyone feels heard and supported while working through their concerns. Once that is done, it is much easier to figure out a plan where everyone feels respected, honored, and at peace.
I am curious…how many of you out there have gone through the process of choosing an advocate? Would you be willing to tell us about it? How did you have these conversations with your family members? If you have not yet, are you thinking about it now? What concerns do you have? Let us know in the comments!