Your Voice When You Don’t Have One

It has been more than 200 years since Ben Franklin penned his famous line about life having only two certainties, death and taxes. As Americans, we are well aware of the latter and all know the consequences of not preparing for next month’s IRS deadline. But when it comes to preparing for our own life’s end, we fall pretty short. I am sorry to say, like it or not, and whether we have a CHD or other chronic illness or not, each of us will someday face dying.

Everyone faces their own mortality in their own unique way. As a former critical care nurse, I have witnessed many deaths. Some people are very clear that they want everything possible done to the end. Others feel differently and prefer comfort, even if it may mean dying sooner. As a caregiver, I can comfortably support either choice.

The difficult scenarios are the ones where no one really knows what the patient would have chosen. I am reminded of an awesome young man I knew who had congenital heart problems. Since he was adverse to medical interventions, he sometimes didn’t follow through with healthcare recommendations for testing or treatments.

When a tragic event left him critically ill, brain injured, medically unstable and comatose, he needed a breathing machine, medications to support his blood pressure, a feeding tube for nutrition and dialysis to treat his failing kidneys. After months, he didn’t wake up or improve. His sister was his next of kin and his decision-maker. Even thought she was told that his brain would never recover, she believed he would one day wake up and be himself. Because she did not know his wishes, her decisions stood.

Five months later, he developed an infection and his heart stopped. Resuscitation attempts failed, and he died. There was nothing wrong with his sister’s choices, but to this day, I can’t help but wonder, if he could have woken up and spoken up for himself, would he have chosen that path? Did we do what was right for him?

A living will would have guided his care. In the United States, It is currently recommended that everyone over the age of 18 have an advanced directive. However, despite public awareness campaigns, a recent poll suggested that only about 25% of the population actually do. Living wills are a type of “advanced directive.” An advanced directive is a generic term referring to any document that gives instructions about your healthcare and/or appoints someone to make treatment decisions for you in the event that you cannot make them for yourself.

It is important to note that a living will does not affect your ability to make decisions and only goes into effect in the event that you become incompetent or incapable of making decisions. Consider it a blueprint to guide your designated healthcare decision-maker. You can choose anyone to be your healthcare decision-maker and your blueprint can be as broad or specific as you want and can include both medical treatments that you do and do not want. It is your voice in the event you don’t have one.

It is my sincere hope that we all live to an advanced age and then pass peacefully without suffering at a time when we feel “ready” to move on. But the reality is, life is unpredictable and can sometimes sweep us sideways and all can change in an instant. Take some time to think about your wishes, communicate with your loved ones, and consider a written advanced directive.

For further information or sample forms, speak to your healthcare provider or an attorney.