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In the Era of COVID-19: Helping a Loved One With Hospital Advance Care Planning

Reprinted from Give In Kind Blog • April 15 2020 • Tara Shafer

Among the multi-faceted complexities of the COVID-19/Coronavirus pandemic is the opportunity it offers families to work inter-generationally to create an Advance Care Plan Guide prior to hospital admission. Such a guide provides clear instructions for family members as to what to do in the event of (any) emergency hospital admission. And while it is always ideal to have this plan in place, many do not. Getting started can be overwhelming on many levels, and most tend not to start without a specific purpose, often a medical concern.

Banister Advisors Advance Care Planning/Preparing for a Potential Hospital Stay breaks it down.  Developed with the guidance of specialized practitioners, including doctors and lawyers, this document walks people through how to plan and prepare for a hospital stay and includes provisions in the event that the person is incapacitated. It contains free downloadable documents, including those which cause hospital staff to lose valuable time scrambling to find. These include a pre-hospital admission one-sheet, as well as forms specific to preparing for a hospital staypatient informationmedication list, and contact list.

In addition, there are legal referrals listed to provide help in assembling a packet including Power of Attorney, HIPAA release form, Physicians Orders for Life-Sustaining Treatment (POLST), among other items that may be hard to locate in an emergency. The purpose of these documents is also explained, which makes me decide to make it a point to fill them out myself. I note that it is oddly empowering even for me as I write this to note that I should tell someone where I keep a list of passwords for accounts, or that I have a dog that needs walking – once I start, it’s not as scary. 

It is unusual to have advance warning of an impending emergency. And yet, in 2020, many millions of Americans exist sequestered and quarantined. We are collectively standing on a shore and watching a tsunami swell. Our vantage points are all different; we cannot assess the impact of the wave before it hits, but we know that it has either broken or will soon break. And no one is certain when it will recede. The strangeness of these circumstances provides an opening to consider questions of mortality in possibly more immediate ways than usually available to a somewhat death-denying culture. 

Vanessa Laughlin, Founder of Banister Advisors, helps people to create Advance Care Plans as a matter of course. However, her work has taken on an additional element of urgency since COVID-19 arrived in the United States. 

These are the three points Laughlin emphasizes:

Acknowledge that this conversation is hard and do it anyway. When asking a parent or a loved one to whom you are offering help, begin by acknowledging that this conversation is really difficult. Be firm that they should do it anyway.

Having an Advance Care Plan Matters for outcomes. In the case of pandemic America, it is also appropriate to consider the suffering and psychic toll on the medical personnel working in an unfathomably overwhelmed hospital structure. These doctors and nurses want to maximize their time and limited resources to provide the best care. If they do not know what medication someone is on, if they do not know who has Power of Attorney, they face unnecessary challenges some of which can become unnecessarily insurmountable.

“Having an advance Care Plan matters. And it’s not just about end-of-life — it matters in terms of physical suffering and the emotional toll on the people you love when they don’t understand how to help make decisions on your behalf in the worst-case scenarios. Truth: facing your own mortality is one of the hardest things you can ever be asked to do. But one way to overcome the challenge is to think about WHO you are doing this advance care plan for, if not for yourself. Think of loved ones, think of frontline healthcare workers, think about others. Sometimes that’s the only motivation we need to get started.” – Vanessa Laughlin

Explain that everyone will sleep better at night. Emergencies are, by their nature, sudden. A COVID-19 infection can be planned for – and if the person with whom you are speaking never needs to use it, that is the best outcome. Be patient and firm. However, having this knowledge when it does become relevant is critical – COVID-19, or not.

This the fifth in a series of articles to provide guidance as to navigating situations we continue to navigate during the COVID-19/Coronavirus pandemic. We recognize that life continues in all aspects, even the pandemic impacts all of us in profound ways. We are on your team now as well as post-pandemic – and beyond. We invite you to visit our library of situationally specific articles here.

View the post on Learn in Kind and learn more about Give in Kind


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