26 Aug Ask Alice September 2020

We answer your questions about Advance Care Planning

Dear Alice,

Getting my Advance Directive (AD) done was my New Year’s resolution, and I was just about to get started when COVID-19 hit.  But with the challenge of the pandemic, I feel really confused.  Suddenly questions about ICUs and ventilators are a lot less abstract than they were before.  I honestly don’t know what I’d want if I get COVID-19!  Not to mention that the information about treatments and outcomes keeps changing.  I don’t even know how to begin to approach these questions.  Plus, it’s all I can do just to put one foot in front of the other day by day.

What should I do?
Regards, Muddled

Dear Muddled,

It’s certainly understandable that you feel confused, and you are definitely not alone.  On the one hand, the constant reminders of sudden serious illness and mortality bring home the importance of getting started on advance care planning sooner as opposed to later; but on the other, the same stresses and uncertainties that compound the importance of working on your AD may also make it more difficult to do so.

Fortunately, we have volunteer facilitators who can help you get past these and  other barriers you may face to getting your AD done.   In your AD, you do not necessarily have to address COVID-19 specifically.  If you don’t, you will still be covered by your choice of agent and the general wishes and guidelines for health care you have directed for any sudden illness, accident, or unexpected neurological event.  But if you do want to use the opportunity to address treatment for COVID-19 specifically, your facilitator can lead you through a series of questions organizing and addressing the issues that are most likely to arise in treating this disease.  (This is based on a form developed by a wonderful organization called Compassion and Choices.)  You can fill out the form, sign it, and have it be an addendum to your registered AD.  Notably, this form specifies that it “is only intended to provide instructions in the event that this person has COVID-19,” so you don’t need to worry if one or more of your wishes if you have COVID-19 is not fully consistent with the general wishes contained in the main body of your AD.

So please give us a call.  It is important to do this now, no matter what shape you’re in, keeping in mind that starting advance care planning is always the toughest part.

Hope to hear from you soon, 
Alice

Dear Alice,

I have a registered Advance Directive, but with all the information that the COVID-19 crisis has brought to the fore, I’m wondering if I should address COVID-19 treatments specifically, and if I should reconsider some of my previous general directions about ventilators and other life support treatments? 

Sincerely,
Wondering

Dear Wondering,

These are reasonable things to wonder about, and I hope the answer to the previous letter provides at least some partial answers.  To reiterate, you do not have to address COVID-19 treatments specifically, and the agency provisions and general wishes in your AD will apply.  But if you do want to think and talk more about COVID-19 treatments specifically, we can help you do this.  If things you have seen and heard make you want to actually change your general wishes in a substantive way beyond COVID-19 treatment, you will need to do a new AD.  Otherwise, if you just want to get more specific about treatments for COVID-19, you can file the form (referred to in the answer above) as an addendum.  The addendum will require signing and witnessing like the AD.

We are here to help with whatever you decide.

Stay well,  Alice 

As always, please contact Don Freeman, Taking Steps Brattleboro Coordinator, 802-257-0775, ext. 101, or don.freeman@brattleborohospice.org, for information about Advance Care Planning.

Till next month, folks.  Please send your questions to Alice via info@brattleborohospice.org.