Addressing advance care planning in the face of COVID-19

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Jennifer Massey

We are facing a new normal. "Social distancing." "Flattening the curve." "Shelter in place." These terms are now part of our vocabulary. As we are learning to adapt, another concept should be added to the mix: advance directive.

An advance directive is a document that puts you in control of your healthcare decisions, even when you are not able to speak for yourself. Now, more than ever, completing an advance directive ensures your wishes about end of life are at the center of your treatment decisions.

Recently, hospitals have had to put strict visitor restrictions in place due to COVID-19. With these restrictions, patients are coming into the hospital alone. It can be unclear who should be making healthcare decisions for those who are very ill or unable to communicate clearly.

Providers are left to track down next of kin, not necessarily working with the person who knows the patient's wishes best. Families might be left to make decisions based on reports from doctors and a few video phone calls.

These decisions are even more difficult if the family is trying to guess what their loved one would want.

So, what can you do? Add "creating a Healthcare Power of Attorney" to the list of the projects you want to get done during your time in quarantine. This will allow you to reflect on what "quality of life" means to you and empower you to make decisions about your healthcare, removing the burden from your family.

It also enables you to pick the person you feel will best support your decisions - not necessarily your oldest child or spouse, but the person who will make the tough choices based on the wishes you have communicated.

South Carolina has several options for writing down your decisions about end of life care. The easiest is the South Carolina Healthcare Power of Attorney (get a copy at BeaufortMemorial.org/PowerOfAttorney). The form has instructions on completion and needs to be witnessed by two people who are not part of your family or medical team. While there is a place to notarize this form, this is optional.

Take your time and carefully consider what is being asked. Then complete the form, initialing by the appropriate line and signing at the end of the document.

After you complete the document, share it! This is not a document to hide away in a safe deposit box. Share it with your family and physicians so they know how best to support you should your health start to decline.

Keep in mind that major life changes - a divorce, diagnosis of serious illness, death of a spouse or chosen agent - might change things, so review the document again after such an event, and create a new one if you need to. Remember to share the changes, too.

While COVID-19 has created this sense of vulnerability and anxiety in our everyday lives, by completing your healthcare power of attorney, you can regain some control. Empower yourself and your family so they may act confidently on your behalf if the need should ever arise.

Jennifer Massey, LMSW, ACHP-SW is a licensed social worker at Beaufort Memorial and manager of Patient Continuum of Care Services for the hospital's Palliative Care Program.

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