What Matters Most

By: Anne Beaver

This Spring has felt different than any I have ever known. As we experience the new life of nature all around us, with the coming joy of Passover and Easter, we have anxiety regarding the spread of a virus that is taking lives and changing our way of life, if only temporarily. The world community, with the dawning awareness of the harm COVID-19 is wreaking, is working around the clock to contain and treat the virus. Many the world over are remaining vigilant in respecting the protocols put in place for the greater public health and sharing factual information to help keep us safe, physically and emotionally. Creative partnerships and solutions are helping to ease the considerable economic burden. Prayers of all faiths are being lifted daily. It seems that everyone has been impacted in some way and we all are doing whatever small part we can to support each other.

April is National Healthcare Decisions Month. Perhaps more than any other April, it seems relevant for all adults to think about the medical choices we would make if we were seriously ill and could not speak for ourselves. This discipline of advance care planning is the willingness to spend some time reflecting on our values and priorities regarding what matters most to us in life and how that impacts our healthcare decisions. Do we wish to receive every treatment available to keep us alive, even if those treatments are painful or of uncertain effectiveness? Or would we rather, at a point we determine, receive comfort care to manage the symptoms of a disease or accident we no longer wish to battle, allowing the disease to take its natural course? Maybe we find ourselves somewhere between these positions.

We think about these sorts of things ahead of time because it is far more emotionally difficult to consider them in the moment of a healthcare crisis and because we may not be able to consider them in the moment, depending on the severity of our symptoms. We think about them ahead of time because it is far easier to convey to those we love what we want when there is not a medical crisis at hand. We think about them ahead of time so that we are more likely to get the treatments we want and not get those we do not want. And we consider them ahead of time because it is proven to be helpful to those who care about us and for us, to know our wishes about medical care rather than to guess them.

During a pandemic, in situations where the need for treatment is greater than the required healthcare resources, necessity dictates that medical care move from a patient-centered model of care to a community-centered model. Physicians are asked to make the unspeakable decision of who would benefit most from the limited life-support resources available. While thankfully this is not the situation in our community at this time, it is wise of us to prepare, and one way to do that is to consider what is most important to us and convey it to those who matter most through advance care planning.

In my work at Big Bend Hospice, I help promote advance healthcare planning. We believe it improves quality of life for the person who is ill and for those they love. We have a program called PEACE – Planning Early About Care at the End, where individuals may receive free guidance in completing their advance healthcare plans by calling 850-671-6029. During this time of responsible physical distancing, we will speak with you over the phone, rather than in person, about how we can best help you. In addition to answering your questions, we can mail a Five Wishes document to you and offer support in completing it or another living will of your choice. We can also refer you to online resources that are particularly helpful, such as Prepare for Your Care, Five Wishes, or The Conversation Project, each of which has specific advice for COVID-19 advance healthcare planning.

Every April since the inaugural date of National Healthcare Decision Day in 2008, Big Bend Hospice has offered a community educational event to encourage advance healthcare planning. Some favorite speakers have been Jim Towey, Jason Rosenthal, and Sally Karioth. This annual event is prohibited this April because of COVID-19. But perhaps we can file for an extension on a National Healthcare Decision Day community event the way some do for Tax Day. It is a joyful thought to imagine gathering again when it is safe to do so. In the meantime, prayers that the efforts of so many on so many fronts are working together for the good of all.

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