As COVID-19 deaths climb in the U.S., some Garfield County medical professionals are encouraging people to discuss end-of-life medical preferences with their loved ones.
“There’s probably no better time to talk about people’s medical care preferences or advanced directives,” said Ryn Calhoon, the Carbondale Emergency Task Force health lead. “Right now, when people are hospitalized, there’s no visitors allowed in, no opportunity for a heart-to-heart conversation with your loved ones — and depending on how sick you get, you’re making decisions in a real rush.”
Advanced directives are a set of documents that inform medical decisions when a patient cannot speak for themselves, often in an end-of-life situation. While they can include everything up to what type of food to feed a patient as well as what music they would like played while in a coma, the two primary documents are a Medical Durable Power of Attorney (MDPOA) and a living will.
When a medical situation goes from bad to worse, questions about how to proceed with care can tear families apart, said Dr. Gary Knaus, a Roaring Forks Family Practice physician with 42 years of medical experience in Garfield County.
“Lots of older patients tell me they’re not afraid of dying,” Knaus explained. “They’re afraid of living in the wrong situation.”
Such documents aren’t just for the elderly. Depending on the medical situation, anyone can become incapable of declaring their final wishes before passing.
“Older people are much more comfortable having the conversation than younger people in general,” Knaus said. “But, this virus doesn’t discriminate.”
Medical Durable Power of Attorney
The MDPOA assigns a healthcare agent with authority to make healthcare decisions. It does not give the agent the authority to manage a person’s finances or pay their bills.
“(The agent) does not need to be an attorney,” Calhoon explained. “Often, they are a friend or a family member, who you trust to make those decisions in your stead.”
Deciding who will be the agent begins with a conversation. Talking about end of life decisions can be tricky, but The Conversation Project can be a good place to start.
The public engagement initiative provides several tools for people to begin those difficult conservations with friends and family, including a COVID-19 preparation guide and a conversation starter kit.
Living will
A living will informs a patient’s doctors whether medical staff should start life-sustaining treatments should the patient enter a terminal condition and are unable to make their own decisions.
“Even if you want to be resuscitated, you should have a living will,” Calhoon said.
In some large cities, hospitals are not resuscitating dead patients who do not have advanced directives stating otherwise because of the increased risk to staff at a time when staffing is stretched perilously thin, she explained.
“That’s not typical for most hospitals,” Calhoon said. “But right now, it’s happening.”
Directive database
Once completed, Garfield County residents have several options for getting their advanced directives into the right hands, Knaus said.
The best option is to file a copy with a family physician, who can then enter the documents into the Quality Healthcare Network, a database available to healthcare facilities across western Colorado. If a person does not have a family physician, Knaus said they can contact their local healthcare facility for assistance logging the directives into the Quality Healthcare Network.
In addition to the network, Calhoon said copies should be stored on a refrigerator and in a medicine cabinet because emergency medical personnel frequently check both locations when responding to a call. The glove box of a vehicle is another good location in case of medical emergency while traveling, she added.
“Give one copy to the friend or relative you’ve designated will be in charge of your care,” Calhoon said.
Beyond a living will and MDPOA, the nonprofit organization Aging with Dignity developed the Five Wishes advanced directive document, www.fivewishes.org, to further manage end-of-life care options, such as funeral guidelines, pain management desires and dietary suggestions.
Call Ryn Calhoon at 970-510-6053 for more information about advanced directive options. Paper copies of Colorado’s Advanced Directive handbook, “Your Right to Make Healthcare Decisions,” are available via U.S. mail from Roaring Fork Family Practice and can be requested by calling 970-963-3350.
ifredregill@postindependent.com