Advanced care planning

Having your advanced care plans documented is best. But the first, most important thing you can do is communicate your desires with the person (or people) who will make your health care decisions when you’re not able to.

Before the days of social distancing, my sister-in-law planned a “Death and Dessert” party.

Many of our closest family members were invited. What may sound morbid was actually quite brilliant because it forced us to address some really important questions: Do we want health care professionals to do whatever’s necessary to keep us alive if and when we get to that point? Or is dying a comfortable death more important to us?

These are usually awkward conversations to have. But let me tell you: Nothing is uncomfortable when you’re eating pavlova.

All joking aside, times are different now. Dessert parties and big gatherings aren’t options. Many people are having to make important health care decisions sooner than expected. And nationwide, we’re hearing health care providers say: “We wish more people would have filled out their advance care planning documents.”

Using COVID-19 as the crutch

We all know that making certain health care decisions is important. But few of us are good at actually doing it. We’d rather talk about it next week, next month or next year.

Time isn’t always on our side. But when it comes to uncomfortable conversations, here’s what is: COVID-19. It’s already an uncomfortable time. And it has a lot of people thinking: “What if I or someone I love becomes seriously ill?” This pandemic opens the door for important conversations.

So bring it up at dinner. Or schedule a special family Zoom call. If no one else is willing to share right now, at least they’ll know your wishes. And you might inspire them to think more about theirs.

Starting the conversation

It’s always a good idea to have your wishes documented. But the first, most important thing you can do is communicate your desires with the person (or people) who will make your health care decisions when you’re not able to. Think of the relief it’ll give your loved one(s) to be able to say, “You know, we actually had a conversation about this, and this is what they wanted.”

Questions to ask your loved ones — and answer yourself — may include:

• Would you want to be on long-term life support?

• Do you know what CPR is, or if it would be effective for you?

• Have you ever considered being kept alive with medically administered nutrition?

In relation to COVID-19, you may ask whether your loved one wants to be placed on a ventilator. What about you? It isn’t about preserving medical equipment. And it isn’t about what you think others might want you to choose. It’s about what matters to you.

Important paperwork

Many physicians struggle to bring up the topic of Nebraska (NETO) or Iowa (IPOST) advance care planning forms with their patients. Especially healthy ones.

But Methodist Physicians Clinic family medicine physician Dr. John Lohrberg said it best: “At some point, we’re all going to leave this world. And if you have an opinion on how you want your care to be handled at that point in time, you should make it known.”

Do your research. And lean on your health care provider to help you make informed decisions.

Questions you may want to ask your provider include:

• What do life-sustaining treatments do?

• Does CPR always break multiple ribs? How might I recover from that?

• What does “shocking the heart” mean?

• What happens when you’re hooked up to a machine for a long period of time?

Given what you learn, you may change your mind over the years. That’s OK! Legal documents declaring your health care preferences can always be revised.

Moving forward

No one likes to think about their own mortality. But if we can find a way to normalize these discussions — whether it’s over dessert or during a pandemic — we’ll be better off because of it.

Remember: The best time to talk about this stuff is when we still can.

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