Advance Care Planning During COVID-19

Now is the time to plan with loved ones before someone is seriously ill.

Most Montanans are fulfilling their duty to their community, family and friends by social distancing. While not a popular subject, there is an important way you can help, write your advance directive, if you don’t already have one. Symptoms can worsen suddenly when you are critically ill, leaving no time to have conversations about what you want your care to look like. The respiratory status of patients with COVID-19 can deteriorate rapidly, reducing the time to discuss and decide on a care plan, making an Advanced Directive all the more important.

No one wants to think about dying, yet talking about your wishes for medical care before you have a serious illness or are at end of life can be one of the most powerful things you can do to help your family and yourself through difficult times.

“As healthcare providers, we frequently have these conversations and there are themes,” said Dawn Porte, a palliative care nurse practitioner with Community Medical Center. “One of them is the notion that people assume or believe their family members ‘know what they want,’ or people think it will not happen to them anytime soon”

The reality is that none of us know, and going through the process of wrestling with what really matters to you at the time of a potentially life-threatening illness or at the end of life can be, distressing for those who are caring for you and for those who care about you. Identifying a medical decision maker, called a Durable Power of Attorney (DPOA), and completing an advanced directive can offer you a sense of control in difficult times and lessen the burden on your family or a trusted individual from having to make very difficult medical decisions during a medical crisis. 

In light of the current pandemic we would like to encourage all individuals over the age of 18 to consider talking about your medical care wishes with someone that you would trust to speak for you if you were not able to do so during any medical emergency and to complete an advance directive.

These conversations are never easy and many have no idea how to even start this conversation with your family or other important people in your life. The following examples from our palliative care specialist, Dawn Porte, may help start this conversation:

  • “Even though I’m OK now I’m worried that I might be exposed to COVID 19 and need to be hospitalized, I want to be prepared for the care I might need.”
  • “It’s important to me to be able to talk honestly with you about my concerns and wishes if I ever become seriously ill or unable to speak for myself.”
  • “My doctor/attorney, says I need to go over my advance directive.”
  • “I want to make sure that I get the best care possible and the type of care that I want, so there are things we should talk about.”
  • “I’d like it to be easy as possible for my family/DPOA to make medical decisions on my behalf if I ever become incapable of communicating my wishes.”
  • “If you are ever in the position where you need to make healthcare decisions for me, it will be helpful for you to know what I really want.”

An advance directive form can be obtained from your primary care provider, attorney or online. The Montana Department for Justice, Office of Consumer Protection and Victim Services has forms, information and a registry on their website, dojmt.gov. Additional information can be found online: theconversationproject.org, CompassionAndChoices.org, respectingchoices.org

Once the advance directive is complete, talk with your primary care provider about your wishes, give copies to your medical decision maker (DPOA) and your community hospital(s). Also consider sending a copy to the Montana End of Life Registry at P.O. Box 201410, Helena, MT 59620. It is also important to know that your wishes may change over time and that your advance directive can be easily updated/changed.

With intensive care units filling up across the nation, it has never been more important, or more helpful, to complete an advance directive. Please prioritize your health by communicating with your loved ones and filling out an advance directive. Your doctors, your loved ones and you will appreciate it.