Valentine’s Day. A time for romance, for hearts and flowers, extravagant gestures of undying love and devotion. A time to really show your loved ones how much they mean to you. This year, I say skip the candy and jewelry, the flowers and dinners. Instead, do something lasting and truly meaningful…create your living will as part of your advance directives for medical care.
Yes, I did just suggest you sit down and write down your wishes should you become incapacitated to the point that you are unable to make your wishes known while in the hospital in the middle of a life-altering, potentially life-threatening crisis. If you want to show your loved ones how much they matter to you, do something now to prevent them from ever having to fight the medical establishment to honor your wishes.
What prompted this unorthodox —and unromantic—declaration from me today? My sister and her in-laws are, this very minute, in a meeting with hospital officials to discuss the possible fate of their youngest family member. He’s forty, perhaps not the picture of perfect fitness and health and, certainly, a man living with personal demons. Who among us isn’t, really? This man is also a beloved brother, son, uncle, friend to many. He is sweet and gentle-natured and has been known to give away his money, his possessions, his time to those in need. He has a reputation for putting others before him.
Friday morning, this man was found unconscious in his home and was rushed to the hospital. No one knows exactly what happened except that he is now in a coma fighting for his life. He suffered massive internal bleeding, is on the verge of multiple organ failure, and has questionable brain function beyond pure brain stem activity (which allows one to breathe). If he survives, he may never be the man his family and friends knew.
Because he did not have a living will or advance directives indicating his wishes for care, the hospital must do absolutely everything in their power to try to keep this person alive —significant amounts of blood and plasma, tests and procedures, mechanical ventilation, mechanical feeding, medications, intensive care facilities, respiratory therapists…and on and on. The hospital’s efforts are contrary to the family’s wishes; the grief and shock the family is experiencing is beyond awful as they must watch and wait. Hoping and praying that his damaged body will let go on its own.
Let me be clear; the doctors all agree that this man’s life will never be the same. He will be alive but may be in a permanent state of complete disability and utter dependence on artificial supports for nearly all bodily functions. However, the law stipulates (and the lawyers admonish heartily) that the hospital must do all it can to preserve the life of this man. Had there been an advance directive, the situation would be very different.
This situation strikes too close for comfort, I know. People don’t like to think about their mortality. Certainly, no one likes to think about the possibility that they could suffer a sudden accident or illness which would leave them unable to communicate their wishes. Take the time now, while you are healthy and able, to discuss your wishes with loved ones and to commit them to an actual legal document. It’s simple to do, though certainly not easy to think about. Niksdad and I had a lengthy discussion about this last night; it left us both raw and gave us much to think about. There are so many shades of gray and unanswerable questions; I think that is why most people avoid the topic entirely.
You will save a world of heartache for those you love and who love you.
Advance directives are comprised of three elements: the living will, a medical power of attorney, and a Do Not Resuscitate order (DNR). Some states honor living wills without the need for a medical power of attorney (California does not).
The Mayo Clinic web site has a good overview of the topic here. Find out more about advance directives and the laws in your state. The National Hospice and Palliative Care Organization has free forms on its web site.