March 22, 2017
By Rachel Behrendt
It’s been quite a month. A coworker was in a car accident and spent days in the ICU, a family member was in a serious trauma and spent weeks in the hospital, and I caught the flu and ended up with a bronchitis that lasted five weeks and made me appreciate how I take breathing for granted. In each of these situations, the person in question was in the prime of life; all three of us had a reasonable expectation of a long life ahead. And yet, with each, it could have ended differently.
My family member was unable to make decisions for himself in the early days of his hospitalization, leaving his wife to navigate the course and make decisions she hoped would be those he would make for himself. Many of the middle-aged people I talked to following his recovery indicate they don’t like to think about how quickly life can change, let alone what decisions might need to be made on their behalf if an unexpected accident or injury occurred.
Each of us should take time while we are in good health and not navigating a crisis to think about and memorialize medical decisions that we would want followed should we not be able to speak for ourselves.
I have been surprised at how many think a living will or advance directive is needed only when one grows old. It’s hard to think about dying when we are all so busy living. The reality is each of us should take time while we are in good health and not navigating a crisis to think about and memorialize medical decisions that we would want followed should we not be able to speak for ourselves. Rather than being morbid or depressing, these conversations with loved ones and the documents that they can draw on to help uphold your wishes are a gift to those who are turned to in times of crisis.
I recently had the great pleasure of working with Rabbi Bonnie Koppell and Temple Chai in The Conversation Project, a project of the Institute for Healthcare Improvement aimed at helping individuals identify their end-of-life wishes. The focus is on taking a step-wise approach to having the conversation with loved ones. This project aims to simplify what is, for many, an insurmountable task. The Conversation Project walks participants through three key activities in medical decision-making: First you think about what your wishes are, then you think about what concerns you have in discussing your wishes with loved ones, then you have the conversation. It’s a great project and Dr. Ron Fischler and Rabbi Koppell have done a wonderful job of leading the congregation in this work. Below I’ve included a link to The Conversation Project’s website where you can find resources and more information.
As a nurse of almost 30 years, I have seen too many times loved ones struggling to intuit what their mom, dad, spouse or sibling would want. While still in my 20s, I made my first living will. Today I am honored to work at Hospice of the Valley, an organization dedicated to helping people as they determine what their wishes are and provide resources for individuals to document their decisions and explain one’s wishes for care in case of a catastrophic medical event.
Many tell us how relieved they are to have put their wishes down on paper. Some said they should have done it long ago. You’ve heard it before, but it bears repeating: Dying is part of living. “Dying well” means so many different things to different people. For some, it means trying everything, no matter what, right up to the end. For others, it means focusing on quality rather than quantity of days.
There is no right or wrong path or belief. But with all the choices, shouldn’t each of us care enough about our loved ones to make sure they know our wishes, so they can advocate for us in the event we aren’t able to speak for ourselves? I think so. Hospice of the Valley has resources for living wills and The Conversation Project has toolkits available. Take a few minutes to get the conversation started today—your loved ones will thank you later.
Rachel Behrendt, DNP, RN, NEA-BC is senior vice president of operations for Hospice of the Valley.