Our lives may forever be defined with time references to “before the COVID-19 pandemic” and everything after that.
One thing that hasn’t changed is the importance of having conversations with your family and health care professionals about your preferences for medical care if you become unable to speak for yourself.
In fact, the pandemic has only highlighted why it’s so important. Patients and family members who had advance care planning discussions prior to the pandemic are prepared when faced with a serious illness or medical crisis.
They are comfortable with health care professionals’ questions: “If mom gets COVID-19, and if it is severe, she would or would not want X, Y, or Z.”
Unfortunately, few families are that well prepared.
Only one-third of U.S. adults have discussed or completed advance directive documents such as a health care proxy, power of attorney, or living wills that help guide family members and health care professionals as to what kind of medical treatments they would or would not like to receive if they are unable to speak for themselves.
Don’t wait for a crisis to have these discussions.
One of the biggest challenges I’ve seen during the pandemic is working with families who have not had any in-depth advance care planning discussions. Whether due to COVID-19 or some other illness, their loved one’s health suddenly declined, and they had not been able to spend much time together because of the pandemic.
Perhaps the patient lived in a facility with visitor restrictions or the patient limited visits out of infection concerns. The patient’s decline seemed sudden to the family, who were not seeing it happen as they normally would over days, weeks, and months.
It was hard for them to believe — and thus hard to think, in that moment — about the crucial need for advance care planning conversations.
Many older adults have vision, hearing, or cognitive deficits and in-depth conversations over the phone or video are difficult. And video chats are not the same as in-person discussions; the conversation flow is different and there often are technical issues to overcome.
It is never too early to start thinking and talking about your wishes for care if your health status were to change. Choose a health care agent wisely who will be your voice when you cannot speak for yourself and have those important discussions about health care preferences before a crisis occurs.
The COVID-19 pandemic opened a lot of eyes about advance care planning. Giving guidance to your family and friends will help you get the care that you want. Your loved ones can feel confident they are voicing your wishes, not their guesses.
Catherine Duffy is a palliative care nurse practitioner at Care Dimensions, a Danvers-based organization serving the North Shore.
