Sadly, the novel coronavirus is wreaking havoc on the lives of older adults. Many more older adults are becoming very ill and dying from COVID-19 than younger people. Now, more than ever, it’s important to have advance directives–health care proxies and living wills–which make clear your health care treatment wishes if you cannot speak for yourself. If you’re diagnosed with COVID-19, you are likely to be better off if you have thought through the end-of-life care you want.
No matter how old you are, it is always helpful to have designated someone to speak for you if there comes a time when you cannot speak for yourself. This person is your health care proxy. It is equally important for your peace of mind and your loved ones’ to talk about your health care wishes.
Right now, many people are infected with or at risk of being infected with COVID-19 and dying, but anyone can get hit by a car or come down with a life-threatening illness at any time. Through a health care proxy, you can help ensure that you get the care you want. Palliative care–care that is comforting, that eases pain and improves quality of life for patients, involves no aggressive interventions. Curative care is intended to extend patients’ lives through aggressive interventions. The decision between palliative and curative care can take time, so it’s good to plan in advance and talk the decision through with the people you love.
N.B. Medicare covers the cost of speaking with your doctor about your end-of-life wishes as part of the annual wellness benefit.
Having a health care proxy is all the more important during a pandemic. Patients with COVID-19 tend to be socially isolated from their families. They generally cannot meet in person with their doctors. They need to have difficult conversations and understand their chance of living. Without a health care proxy, they might need to make rushed decisions about the care they want in the most stressful of situations.
Hospitals often will help a person make end-of-life decisions on intake. But, in the midst of this health care pandemic, hospitals might not be able to. In some cases, hospitals will simply ask patients whether they want life support. Without understanding the benefits and risks or having the time to consider them, it can be hard to make good decisions. People might not understand that a decision to elect life support could mean two weeks alone on a ventilator, apart from your kids and grandkids, and then death.
The choice of palliative care in the case of COVID-19 should mean that the palliative care provider is in touch with the patient’s kids and grandkids, keeping them apprised of the patient’s health. Patients are comfortable and will not go to the ICU or get put on a ventilator. Instead, patients might be able to spend time with their loved ones.
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