Wednesday, July 15, 2020

COVID, Ventilators and Your Healthcare Directive

In April, 91-year old Minna Buck revised her Advance Healthcare Directive. She doesn’t want to be intubated if she becomes infected with COVID. Ms. Buck has done her research and knows she doesn’t want any part of intubation. She knows that even if she survived, the recovery would leave her weak and disoriented, a burden on others, with a negligible quality of life.

No Intubation for Ms. Buck

Buck is clearly in the high-risk group. “No intubation,” she wrote in large letters on the form, making sure to include the date and her initials. “I don’t want to put everybody through the anguish,” said Buck.

Ventilators represent a loss of personal control

For older adults contemplating what might happen to them during this pandemic, ventilators represent a terrifying lack of personal control. Ventilators pump oxygen into a patient’s body while he or she lies in bed, typically sedated, with a breathing tube snaked down the windpipe. This can be the greatest fear: helplessly being hooked to a machine with the end of life looming. Yet for others, there is the hope that the machine might pull them back from the brink, giving them another shot at life.

Who will care for these patients? Where?

“It’s a very long, uphill battle to recovery,” and many older patients may never regain full functioning, said Dr. Negin Hajizadeh, an associate professor of critical care medicine at the School of Medicine at Hofstra/Northwell on New York’s Long Island. “Who’s going to take care of these patients after a prolonged ventilator course ― and where?”

Quality of life issues motivated one single woman to change her healthcare directive

In St. Paul, Minnesota, Joyce Edwards is 61, unmarried and lives alone. In late April, Edwards revised her Advance Healthcare Directive to specify that “for COVID-19, I do not want to be placed on a ventilator. I have to think about what the quality of my life is going to be. Could I live independently and take care of myself — the things I value the most? There’s no spouse or adult children to take care of me. Who would step into the breach and look after me while I’m in recovery?”

End of life care discussions: Think about what’s important to you

COVID has created some immediacy around end of life decision-making. Experts advise older adults to discuss what’s most important to them–independence, time with family, mobility, living as long as possible. Think about what represents a good quality of life—this will provide context for the ventilator decision. For Minna Buck, quality of life and independence outweighed living as along as possible. At 91, she has lived a long, full life.
During this health crisis, many are feeling an urgency to create a Living Trust 
As the COVID crisis drags on, more clients are scheduling appointments to create or update their Living Trusts. Our Trust package includes a Pour Over Will, and for those families with children under 18, it means that they can name a Guardian. Creating a Trust helps provide some peace of mind during these uncertain times. Best of all, we guide you through it and we prepare the legal documents.
Our Trust package includes a Will, Power of Attorney, an Advance Healthcare Directive and Incapacity Planning. At California Document Preparers, for most of our services, we charge one flat fee. We’re helpful, compassionate and affordable.

Schedule an appointment today

Our offices are open and we’ve instituted stringent sanitation procedures. We can also provide our services virtually via Zoom or phone. Schedule an appointment today at one of our three Bay Area officesin Dublin, Walnut Creek or OaklandPlease wear your mask and stay safe.

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