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Bringing Up the Tough Questions

Welcome to Caregiver Friday!

I read an article yesterday about having those deep discussions about the patient’s desires regarding their medical care.  The items on the checklist include all items on the continuum including end-of-life care.  The suggestion or the point being debated, not sure which it was, was that since families come together for the holidays, this is a good time to have those discussions.  I don’t know about you but I wouldn’t exactly want to say, pass the mashed potatoes and oh by the way would you ever want to be on a respirator.  I do believe there is a time and a place for everything.

I would like to make it clear that I do believe it’s important that the patient have a living will and a durable medical power of attorney.  In most cases, you the caregiver, will the the power of attorney.  It’s for that reason that I do believe that you as the caregiver/wellness partner become assigned the task of making sure these documents get completed.  I know you’re thinking, “sure…one more thing for me to do”.  The truth is that if you have these documents in the long run, should be patient not be able to make their own decisions, it will actually provide you with direction making decision making on the patient’s behalf clear.

I’ve played around with a lot of different methods of approaching these topics with family and friends.  I’m currently the durable power of attorney for medical care for all my family members, my spouse and my best friend.  Instead of bringing up these uncomfortable questions as part of a medical inquisition I am allowing the media to be my point of entry for all discussions.  I watch for news articles, television segments and reported studies so that I can casually bring it up in conversation.  Back when the big news story was the Schiavo case it gave me an opportunity to explore the ideas of withholding food and water.  The questions don’t come out of the blue and the person is engaged in conversation that is stream of consciousness, from the gut.  These answers tend to be how the individual feels without the censors installed instructing him/her on how to make everyone feel less uncomfortable with their illness.

The reason it’s important to have it written down is that if contested in the courts simply stated that you know the person’s wishes won’t suffice.  You can download the forms for your state online and then simply have them notorized.  A copy should be given to the doctor, put in the patient’s chart at the hospital and you, the caregiver/proxy should have a copy.  Everyone does not need an original of the document, copies are fine.

There was a book on leadership and I found a gret quote, “Find people who will tell you the truth and reward them for it.”  Share that quote with the person for whom you’re providing care.  Telling them the truth about the importance of these discussion should be rewarded.  It’s not about you losing hope or believing they’re declining, it’s part of the illness process.  We know that you both have been having these conversations internally from the moment the doctor said, “I’m sorry to tell you…”.    We all have anxiety around our health and when there is a spotlight on it we’re more sensitive.  Bring it out in the open and rid yourself of the high anxiety.  There will most likely be small amounts of anxiety, it comes with the territory.

Save the holiday season for creating warm and loving memories.  Utilize this time for connecting with friends and family.  Allow yourself to experience the joy of the season; it doesn’t have to be related to any specific religion or tradition, but the essence of peace and happiness.  There will be time (in most cases) do take care of the hard questions after the holiday.  It’s not like we’re talking months, but everyone deserves a break from focusing on the illness, think of it as a mini-vacation, just don’t take a vacation from medication and treatment.

I wish you and your family a happy holiday season.  May it be filled with love and laughter.  May you feel connected to others allowing that energy we call love to permeate your soul and fill you up.

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