Same Story, Different Day in the ICU: Families Still Caught Off Guard During Emergencies

We kept encountering the same scenario over and over again, like Bill Murray in Ground Hog Day. Patient after patient and family after family play a guessing game with what their loved one would have wanted while they're in the ICU with Covid-19. They weren’t prepared for a medical emergency; neither the patient nor the family. It doesn’t have to be this way.

How would you answer these questions in an emergency when your loved one can’t talk or communicate for themselves?

Does she have a Power of Attorney for Healthcare? Do you know who it is? Can you get us a copy?

• Does he have a living will or an advance directive? Did you talk with him about it?
• Has she ever talked about life support measures? What do you think she would say if she could stand right here next to us and see all of these machines? Would she want this?
• Do you know if he would want to live the rest of his days with a trach on a ventilator with a feeding tube in his stomach?
• Would she like anything from home around her while she is here, perhaps music or a religious artifact?
• Do you have a special message you would like to prepare for him or something you’d like to tell him or possibly read a prayer or a poem, in case you don’t have a lot of time left with him?

Families are caught off guard and unprepared in emergency situations every day. Decisions have to be made. If a person isn’t designated to make decisions in an emergency, in writing, with known wishes already conveyed, the responsibility is “assigned” based on the Surrogate Act that names decision-makers in a specified order. And it isn’t always a person that is best-suited to make those decisions.

Healthcare teams provide the decision makers with their best assessment of the situation and available choices with risks and benefits that accompany each decision. They rely upon people that know the patient best to speak as best they can for that person. Ultimately the chosen power of attorney or the “assigned” surrogate decision maker has to make decisions. It is easier to make those decisions if you have had conversations about life support measures well in advance of an emergency.

Ultimately the chosen power of attorney or the “assigned” surrogate decision maker has to make decisions. It is easier to make those decisions if you have had conversations about life support measures well in advance of an emergency.

This is why advance directives are worth their weight in gold. This is why the tough conversations and the uncomfortable topics and the details matter. This is why talking about these things when you are well and healthy and continuing these conversation as you grow older makes sense. It’s not taboo! It’s life. It’s that simple. Life has ups and downs and messes and drama. Death is one part of it. Not all of it. Have the talks, name a person, write it down, let everyone know how you feel and what you want. And change it over time as you need.

Just do it. Be the family that has talked about death and dying and know if you ever need that person to be there in THIS way for you, they will be. And then you can literally and figuratively rest in peace.

“Everything that has a beginning has an ending. Make your peace with that and all will be well.” – Jack Kornfield