The weathered brown leather briefcase sat open on the kitchen table ... no longer hidden away in the closet awaiting its next outing. Instead, the combination locks were released, and the contents of the old case were now in plain site for all gathered around to see. Bible passages, poems and other notes. The Living Will document now prominently placed on top all the other documents. My grandfather was dying.
Nearly six months prior, he made the decision to stop rehabilitative treatment from a fall that left him with a severely broken back and a post-surgical infection resistant to antibiotics. He put up a good fight but decided the grueling treatment with little results were no longer worth the suffering he was enduring. He went home to his favorite chair and prepared to enjoy what time he had left through the help of hospice care.
In those final days as the end was drawing near, it became heartbreaking at times to no longer do those things one typically does to provide care for a sick family member. His wife, so accustomed to their normal meal routines, struggled to no longer bring a plate to grandpa. His body, now no longer able to use the nutrients in the food, was showing signs of the food becoming burdensome to the process now occurring. He was slipping further from us with each passing day.
Tears fell as his wife cried out that she felt she was killing him by not feeding him. The hospice team reassured her that she was not. In fact, she was doing exactly what he had asked her to do through the instructions in his living will. He had been firm and confident in his decisions made long before his final set back. She ultimately found some comfort in this and adjusted to her new role by his side.
"You Can Be Thoughtful In the Process"
It struck me as I drove from my grandpa's house that day how oddly similar having advance care plans in place for the end of life is to have a birth plan in place for expectant mothers. Ideally, the plans are put into place months, if not longer, ahead of time when one is of a clear mind. You can be thoughtful in the process and take the time to share your wants and wishes with those closest to you: your family, friends, physicians and spiritual advisors.
In advance directives, you can provide details of what is important to you, what steps you want followed and what things you do not want. People can ask questions of your plan, reaffirm your choices and know what they are tasked with fulfilling for you. They are charged with helping you fulfill your wishes even in the hardest of moments when it might be easier to try to ease the pain. When the moment arrives, everyone is ready. The bag, or briefcase is packed, and ready to go. Not having the plan in place can cause confusion, anger and decisions made in haste during what can become incredibly stressful moments.
Do you have your plan in place? Have you taken the time to educate yourself on the various choices available to help guide you in putting advance directives in place?
Getting Started On Advance Directives
Selecting a healthcare representative is a great first step followed up closely with a living will. Neither require the assistance of an attorney or notary. There are various other documents and estate plans from which to choose. Talk to your spouse and family to decide what is best for you from a medical and financial perspective and review state guidelines carefully. It is far better for you and for your family to have your plan in place. It is one final gift to your family - a gift of peace knowing they gave a voice to and respected your wishes in your final moments on this earth.
By Megan Wright
Manager, Provider Engagement & Communication, Franciscan ACO