Provide Peace of Mind, not Tough Choices

As I walked into the ICU room, I noticed a terminally ill patient who was receiving every life sustaining medical intervention available. Tubes and monitors were everywhere, small electrodes were taped to the patients chest, and an IV was in his arm providing fluids.T he artificial light was less than unwelcoming. Three adult children and his spouse were standing around the patient with the unfortunate task of deciding just what to do. The impression I had of the loved ones was one of shock, overwhelming grief, and bewilderment.

My thoughts turned to my elderly grandfather, and his expressed wishes about what he would want at the end of his life. He has always been very clear that he wanted no invasive medical treatment when he faced his own death. He states clearly that his priority is to be in the small house he built for himself and his sweetheart, gazing out at their beloved garden, and hopefully lasting just a few minutes longer than his devoted wife of 74 years.

As my attentions turned back to the family before me, I tenderly asked this question, “Did your dad ever express to you what he would want at the end of his life?” The answer was No. The family needed to know that one of the choices they had for their dad, who could no longer speak for himself, included the compassionate, dignified care that hospice can offer.

When a patient is unable to communicate, medical professionals turn to family members for decisions. In Washington State, our laws define an order of persons who would be authorized to provide informed consent for treatment.(RCW 7.70.065) The law gives authority in the following order of priority: the appointed guardian (if any); an individual whom the patient has given a durable power of attorney for healthcare decisions, spouse or state registered domestic partner, adult children, parents of an adult patient, and adult siblings.

Choices that might need to be made for a patient include: life-sustaining treatments such as CPR, artificial ventilation, feeding tubes, dialysis, etc. Other decisions that are frequently involved include placement in skilled nursing facilities, application for state and federal benefits, or hospice care. Loved ones who are asked to make healthcare decisions, are often given this task without being clear as to what the patient would have wanted. This experience has been proven to cause depression, anxiety, post traumatic stress disorder, and prolonged grief.

There is a simple way to prepare your loved ones for difficult medical treatment choices. Complete a Living Will and Durable Power of Attorney for Healthcare, TODAY! Providing direction for our loved ones is a responsible and compassionate act.

You can obtain a living will (or advance directive) document from many websites for free! Caring Connections or Hospice of the Northwest are just a few. Simply follow the directions of the forms, paying attention to the witnessing requirements. Many of our area hospitals are offering free workshops to provide information about these crucial forms.

I know that any decisions that my family will need to make for my grandfather will be in the context of his expressed wishes. We will have a frame of reference for any decisions made for him, based on keeping him in his own cozy home, in view of the garden, and close to grandma. In honoring his wishes, we honor his life and the contributions he has made to our family. While we will all mourn the passing of this heroic man, our grief will be comforted by the direction he has given us.

Give your loved ones peace of mind, not tough choices!

Resources for living will/advance directive forms:

Jill Boudreau serves as the Community Liaison for Hospice of the Northwest. She teaches Five Wishes living will workshops throughout Island, Skagit, and Snohomish Counties.To contact Jill, call 360-814-5550 or