My Blog: Good Decisions

I was in a room listening to physicians talk about intensive care and how timelines were important to patient care and to providing health care. Patients get better when they’re treated. Or they don’t.

If they get better, doctors know why. And the same is true if patients don’t get better. If certain things were going to happen, like recovery, then they would have happened.

The importance of recognizing that trend along with all the other information available is freeing. It can free you to choose well. It can enable a person to have a good death and a good life in the sense that there’s life to live after the next decision.

Planning for Later

Every now and then, I want to point to the increasing need for people I love to have hard conversations about life, about living, and about dying. As an educator and pastor and father and relative, this video touches upon some critical issues worth talking about.

I don’t agree with literal exactness that we can or should choose the way we die, but I do agree with the intentionality behind living well, planning for later, and communicating with loved ones over these matters. I do believe in exercising as much right as we have. And we have the right to communicate our wishes around intensive medical treatment, aggressive and life-sustaining measures, and so forth.

This video feels close, real to me. Even though that rapid response team is small by the comparisons at NMH. I’ve seen 15-20 people in a room and crowding a hall easily, cracking ribs, pumping and sticking, and pounding and trying. And then a nurse, timing the scenario, calling for another person to step up and take over. I’ve seen that for 30-45 minutes.

Beyond that, listen to the story of the video and talk to people about an advance directive for healthcare. And if you can, let that be a part of other important conversations.

And that’s not including talking about money and life insurance and diet and family history. There are many conversations to have. But this one is important.

It’s not morbid. It’s responsible. It’s not short-sighted. It’s visionary and realistic. It’s helpful for you to think through things about your care. It’s relieving for those you love.

Decisions, Decisions, Decisions

The year we got married we made a lot of decisions. We purchased a fixer-upper. We had to get a car. We built a garage and searched for a lawn mower at the hardware store my father sent me to over in the Back of the Yards.

We also completed a budget together, elected an executor of our estate, little estate that we had as twenty-three year olds, and chose agents to make healthcare decisions for us if and when we couldn’t make those decisions for ourselves.

I selected my brother Mark, both because I trust my brother and because I didn’t want my wife to be in that situation. Mark will answer his phone and talk through the implications with a medical team, with my wife, with a cool demeanor. Mark will make sure I’m cared for.

I wanted to plan ahead and put that responsibility on my brother’s shoulders. That advance directive is still in place. Mark decides for me if I can’t decide for myself. He communicates for me if I can’t communicate for myself.

At a recent family dinner I reminded everyone of this. We were actually celebrating my mother’s birthday last fall, and I took the moment to nudge my loved ones to plan in advance. I told them that I didn’t want to live in a prolonged state if I had been oxygen-deprived for longer than 10 minutes. I gave specific instructions, in the presence of my family, to my brother and to the others. Mark’s the agent but they all heard about my decision. Again and again, I will remind them that there are wishes I have regarding my medical care. I will refine those as I go and certainly the longer I’m in healthcare as a chaplain.

Today is national healthcare decisions day. I went to a program about it here at the hospital. Randi Belisomo spoke about her organization, Life Matters Media, and talked about the simple and important process of choosing an agent. Of course, as a chaplain, I walk through the steps of this simple process with people. I witness their completion of the healthcare power of attorney form. And sometimes I get to tell people how vital it is to do this simple thing.

If you don’t choose a person to speak for you, the law has answered your lack of choice. The law puts surrogates in place when you have not chosen. Someone always speaks for those who don’t speak for themselves. So, today, if you haven’t chosen a person to stand in your place, to communicate for you what your medical care should look like, and how aggressive those interventions should or shouldn’t be, consider it. If you need to update your form, the form generally opens with something like, “This Power of Attorney Revokes All Previous Powers.” You can change it at any time.

Consider your feelings and thoughts on these matters, taking the opportunity to involve your family in your thinking, in your care, and in your planning. Communicate your wishes to your loved ones and to your agent, and realize that this is a good way to communicate what you want so that that doesn’t have to be decided for you. Document it on your state’s version of the healthcare power of attorney, and these don’t have to be notarized or done by an attorney, as long as you have a witness who isn’t named as the agent. You’ll want to consult your state’s version because every state is different, but they should be similar from one to another.

If you’re in Chicago today, Life Matters Media is working with the Chicago Public Library at two locations this afternoon to explain these advance directives and to help people fill these documents out. For more information, look here at Life Matters Media.

For the Illinois form, you can visit my hospital’s page and print off a copy.