If something were to happen and you could no longer tell people what you wanted, what would you want loved ones to do on your behalf?
It’s a conversation for another day for many. Except it’s not too early to take care of it and it’s not too difficult. And answering this set of sometimes difficult questions can lead to peace. It can also do a great favor for the people you leave behind.
An advance directive is a form that a patient fills out to describe the kind of medical care they would want to have if something happens and they can’t speak for themselves.
Lindsey Dahl, M.D., specializes in geriatric care and internal medicine. As part of her profession, she is often involved with families who have to take on some of those decisions.
Make decisions while you can
Advance care planning sometimes comes too late. It’s why it’s something to think about when you’re able.
“There could be an accident, God forbid, that could challenge your thoughts and beliefs about what you want done with your body,” said Dr. Dahl, who works at the Sanford Southpointe Clinic in Fargo, North Dakota. If you don’t communicate those things to the people you love — and have a document — then we don’t know what you want in those instances.”
It is why she encourages people of any age to have necessary conversations with family and create an advance care plan that spells out your wishes should you no longer be able to express them yourself.
“It places a lot of burden on others when they have to make these decisions for us,” Dr. Dahl said.
Sherm Syverson is executive director of Emergency and Trauma at Sanford Health. He has also endured an aggressive bout with COVID-19 that sent him to the hospital.
Paramedic speaks from experience
He will tell you he is not an expert on executing advance care directives. As a longtime paramedic he has seen a lot of accidents, however, that involve end-of-life issues. In some cases, these things are happening earlier in life than anyone would expect.
“From my early days involved in emergency medical services, some of the most impactful calls I ever went on were when someone suffered a very traumatic injury with no chance of recovery in the long-term,” Syverson said. “I can tell you the people who were most prepared to have the difficult conversations tended to be older. When you have a younger person involved it can be truly devastating for families when they don’t know what the loved one’s wishes are.”
Download our booklet: Sanford Health guide to advance care plans and health directives
When Syverson was hospitalized with COVID-19, he was not in danger of dying, but it did give him time to think about the situations he’d been witness to in the past. His wife was also sick with COVID-19 at the time.
“We talked about what it would be like if neither of us could make our decisions,” Syverson said. “Do we have people lined up to help make medical decisions if we’re not able to make them ourselves? And the answer was no, we didn’t have those things lined up.”
Since then, Syverson has answered some tough questions and shared answers with loved ones. His conclusion after completing the process is that in some ways, it was very positive for him and for those he was sharing these decisions with.
“You should not be afraid to initiate conversations about yourself or with elderly relatives,” he said. “It can actually be an enjoyable conversation. I remember talking to my own father, who died of cancer. We had discussions about what he really wanted out of the remainder of his existence. It wasn’t like we were all breaking down and distraught. It wasn’t like that at all.”
‘Nothing to be scared of’
Instead, it was earnest, honest and of great value to the family.
“There is nothing to be scared of. It doesn’t have to be scary,” he said. “It can be enlightening to make your wishes known. Think about what a gift it is to your family. If they’re put in that position, they know what you would want.”
Sanford Health provides ample resources to make formulating an advance care plan an easy-to-understand series of decisions for both you and the people you love. There are nurses who can walk you through the whole process. They can answer questions you have and counsel you from start to finish.
They can also point you toward websites that can answer your questions about what to consider and how to go about getting it documented.
Dr. Dahl has discovered the process of creating an advance care directive is not the biggest obstacle in many cases. Confronting mortality can be a more significant hindrance.
“We avoid talking about death in our country,” she said. “But it is important to think about and discuss with our loved ones our goals of care and what conditions would make life not worth living. The advanced care plan workbook helps you walk through these important questions.”
How to make an advance directive
A comprehensive advance care directive guides you to:
- Think about and discuss treatment options with your family and health care providers.
- Make treatment decisions based on personal goals and values.
- Select someone you can trust to make decisions on your behalf.
- Document and communicate decisions to those who need to know.
Forms and details for advance directives vary by state, but generally, the following issues are covered:
- Naming of the health care agent, also known has health care power of attorney
- Treatment of specific health conditions
- Treatment wishes to prolong life
- Organ donations
- Autopsies
- Treatment wishes for restoring life
- Treatment issues when permanently unconscious
Patients can receive an advance directive form at their primary care clinic, during a hospital visit, through My Sanford Chart or download a free planning guide.
Learn more
- Advance care planning: Holidays can be time for good talks
- Natural death: Practical information for this phase of life
- Long-distance caregiving brings unique challenges
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Posted In Emergency Medicine, Family Medicine, Fargo, Healthy Living, Internal Medicine
