As I walked into the ICU room, I noticed a terminally ill patient who was receiving every life sustaining medical intervention available.  Tubes and monitors were everywhere, small electrodes taped to the patient’s chest, and IV in his arm, providing fluids.  The artificial light was unwelcoming.  Three adult children and spouse were standing around the patient with the unfortunate task of deciding just what to do.  The impression I had of the loved ones was one of shock, overwhelming grief, and bewilderment.

 My thoughts turned to my elderly grandfather, and his expressed wishes about what he would want at the end of his life.  He has always been very clear that he wanted no invasive medical treatment when he faced his own death.  He states clearly that his priority is to be in the small house he built for him and his “sweetheart’, gazing out at their beloved garden, and hopefully lasting just a few minutes longer than his devoted wife of 74 years.  

 As my attentions turned back to the family before me, I tenderly asked this question, “Did your dad ever express to you what he would want at the end of his life?”  The answer was “No.”  The family needed to know the choices they had for their dad who could no longer speak for himself, to include the compassionate dignified care that hospice can offer.      

 When a patient is unable to communicate, medical professionals turn to family members for decisions.  In Washington State, our laws define an order of persons who would be authorized to provide informed consent for treatment.  (RCW 7.70.065) The law gives authority in the following order of priority:  The appointed guardian (if any); An individual whom the patient has given a durable power of attorney for healthcare decisions, spouse or state registered domestic partner, adult children, parents of an adult patient; and adult siblings.

 Choices that might need to be made for a patient include life sustaining treatments such as CPR, artificial ventilation, feeding tubes, dialysis, etc.  Other decisions that are frequently involved include placement in skilled nursing facilities, application for state and federal benefits, or hospice care. Loved ones who are asked to make healthcare decisions are often given this task without being clear as to what the patient would have wanted.  This experience as been proven to cause depression, anxiety, post traumatic stress disorder and prolonged grief. 

 There is a simple way to prepare your loved ones for difficult medical treatment choices. Complete a Living Will and Durable Power of Attorney for Healthcare TODAY!  Providing direction for our loved ones is a responsible and compassionate act.

You can download and print off a form directly from out website - click on the Helpful Resources tab.

Jill Boudreau

Community Liaison

Hospice of the Northwest