As strong, healthy, decisive individuals, we generally value our autonomy above all. This is a good thing. However, it often is short-sighted to assume that our lives will not change, or that our decisions of the past will apply in all future situations.
There is no easy way to plan for future health care choices. It's a process that involves thinking and talking about complex and sensitive issues. If you follow the news, you have heard about some situations in which choices are left up to others and you might wonder how or why that was allowed to happen. Often there are no warnings of devastating changes in health status; at other times, there is a long illness which may or may not give a person time to consider options and make one's own decisions.
Let me be clear to say that this is not referring to one's last will and testament, finances, property ownership or assets. This is about who will speak for you when you are no longer able to speak for yourself. Who will be your agent, who will work with your healthcare team for your best interest, This is about that inevitable transition that we all will come to – from this life to Life Eternal. The end of life only rarely happens in 'the blink of an eye.'
The death due to ALS of a notable dean of the University of St Thomas is well-documented in the book “We Know How this Ends,” written by Bruce Kramer, with Cathy Wurzer of MPR. There were many decisions about quality of life during his prolonged illness; and he had the courage to write about them for the benefit of others who may face similar situations.
As your parish nurse, I have worked in the settings of healthcare involving many difficult decisions required of patients, their families, their physicians, their other healthcare providers. There are no easy ways to plan for future health care choices; it's a process that involves thinking and talking about complex and sensitive issues. People have the right to have the healthcare team tell them about medical choices, the risks and the benefits of each of the options, in terminology that is understandable and clear. The patient has the right to accept or to decline these choices.
The Advanced Care Planning Guide, of Honoring Choices MN, helps a person share thoughts, feelings, concerns with the healthcare team, family, friends, and spiritual advisors. Consider the health conditions that you may have now, or may likely encounter in the future; and consider the treatment options currently in practice. Whatever your personal decisions are about certain treatments, it's important that you discuss your point of view with the people closest to you. It is also a good idea to put your choices in writing.
It's challenging to think about having to make these decisions, and it's more difficult to make decisions when you don't know what you want because you've never considered what you might want. Additional information and forms to complete are available at www.honoringchoices.org.