The scourge of COVID-19 is spreading. Thousands of Americans are dying.
What can you do to help? Yes, practice social distancing, wash your hands, and donate masks to local hospitals. Also, talk to your loved ones about advance care planning.
Advance care planning means contemplating and deciding the type of medical care you would want if you had a life-threatening illness; you are never too young or too healthy to start these conversations. It involves identifying your goals and values, learning about life-sustaining interventions — such as cardiopulmonary resuscitation (measures to restart your heart and breathing), intubation (use of a ventilator to help you breathe), or artificial nutrition (being fed through a tube in your nose or stomach) — and sharing with loved ones and your doctors your preferences. An advance directive is written documentation of these preferences.
These preferences are not set in stone and can be revised. Doctors will ask you about your care as long as you can communicate. If you are unable to communicate, doctors will ask your loved ones. Advance care planning empowers loved ones to advocate for the type of care you would have wanted and doctors to provide care honoring your wishes.
COVID-19 can affect the chronically ill and the healthy, the elderly and the young. Patients with severe COVID-19 pneumonia can struggle to breathe and deteriorate rapidly. Decisions regarding CPR, intubation, or transition to comfort care are made quickly. When patients are too sick to respond, their loved ones are asked to speak on their behalf. Protective isolation measures for COVID-19 preclude loved ones from sitting at the bedside for these decisions, making an already challenging discussion more difficult. If a loved one cannot be reached, the breathless patient will be intubated, and resuscitation will be attempted.
In this crisis, where patients are sick, distressed, and isolated, knowing what interventions a patient would want and making these wishes clear is critical.
While you are home with family during this time of social distancing, do your homework. Discuss these three key components of advanced care planning with your loved ones.
Ease into the conversation by utilizing free guides at The Conversation Project and the National Hospice and Palliative Care Organization. It doesn’t have to be morbid; turn the conversation into a game night (over FaceTime or Zoom if needed) by playing Go Wish or a socially-distant Death Over Dinner party.
Advance care planning brings up challenging emotions, and these conversations can be hard. But the day your loved ones are asked what you would want, this planning will make those conversations less distressing, and will enable your doctors to provide the best care for you.
During this pandemic, do your part to help. Get your affairs in order now, because COVID-19 won’t wait.
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