Discussing Advance Care Plans During COVID-19

As thousands of COVID-19 cases were reported in our country and more and more patients were placed on ventilators, the importance of having an advance care plan became a hot topic. An advance care plan lets your loved ones and your doctor(s) know what medical interventions you want and don’t want in the event you are unable to speak for yourself such as an accident or sudden illness such as COVID-19.

Advance care plans are not just for those who are aged or seriously ill.

Advance care plans are for anyone of any age because, as we have seen with COVID-19, illness knows no age limits. Having a plan is especially important for those with pre-existing conditions as they are most vulnerable to the virus.

A recent article in the Journal of the American Medical Association (JAMA) stresses that goals of care during COVID-19 are important for both patients and clinicians as health systems face possible shortages in equipment due to the spread of the virus. It is also important given how this particular disease attacks the respiratory system and how the treatment may have a lasting effect on quality of life for certain patients who are on prolonged life support.

Even if you don’t want to outline specific medical interventions, as outlined in a Living Will, you should have a healthcare proxy, as designated in a Healthcare Power of Attorney. A healthcare proxy is someone who knows your wishes and can make decisions based on discussions with clinicians as your condition changes. Be sure this person will be your advocate and adhere to your wishes no matter what the outcome. For that reason, sometimes those closest to you may not make the best choice as a proxy.

For many, it’s a topic they don’t want to discuss due to fear or discomfort in discussing the inevitable fact of life – death. However, it is an important one to have, especially now.

Having a plan in place can help reduce stress, anxiety and even guilt for loved ones left trying to determine what medical interventions you would want should you be unable to tell doctors yourself.

Lower Cape Fear LifeCare started its Begin the Conversation initiative in 2009 to help people tackle this sometime uncomfortable conversation. Our workbook suggests ways to help begin the conversation:

  • Use a reference point such as the death of another person, a relevant news event, a book/article/TV episode, etc. Begin by asking what the other person thought about it and see if this can lead into deeper discussions.
  • Think about your own preferences. Put your decisions in writing, Then, open the conversation by sharing your own thoughts, rather than putting the other person on the spot.
  • Use two-way communication by allowing your loved ones to share their own beliefs/choices/preferences and use them as a point of conversation or contrast to your own.

With many states still under stay-at-home orders and the fact that social distancing is going to be with us for a while, keeping more and more people at home, now is a good time to talk to loved ones about your goals of care.

Use this time of togetherness to get plans in place and let loved ones know what you would want should you suffer the most serious effects of this virus.

A recently added blog to our LifeCareResponds.org answers questions, provides needed documents and offers people the chance to request our free workbook, which offers suggestions as to how to begin the conversation about advance care plans. As we begin to recover socially from COVID-19, we will resume our free monthly Begin the Conversation workshops, and offer these workshop at no charge to churches, organizations and groups upon request.

Remember, when it comes to advance healthcare plans, it’s better to be ten years too early than ten minutes too late.