There may be only one conversation more difficult than telling children the facts of life. It’s telling loved ones what you want at the end of life.
Patients treated through the Franciscan Missionaries of Our Lady Health System are going to get an extra nudge to have that conversation.
The health system, which includes Our Lady of the Lake Regional Medical Center in Baton Rouge and medical facilities across Louisiana, is emphasizing the need for adults to not only think about their end-of-life wishes but to take tangible action to make sure those wishes are known and followed.
“Imagine you are in the intensive care unit of a hospital following a serious accident or you just suffered a major stroke or heart attack,” said Lee Ann Barbier, advance care coordinator with the health system. “Your doctors believe you’re not going to live or, if you live, you’re not going to be able to recognize or interact with your family or friends. Would your loved ones know what preferences for care you would want?”
Louisiana is behind most other states in terms of having people create living wills and assigning someone to serve as their health care power of attorney in case they become unable to speak for themselves in a medical crisis, Barbier said.
Doctors and facilities in the Franciscan health system will begin asking patients who come in for routine procedures whether they have made the necessary plans and, if not, provide resources for completing the work. Soon, trained facilitators will be available to guide individuals through the process.
After all, Barbier said, even if their visit isn’t for a life-threatening issue, there’s no telling when an accident or sudden health crisis like a stroke or heart attack can render them unable to communicate.
“You don’t know who you are or who you’re with at that moment,” she said. “So, you can’t speak for yourself and say, ‘My life has been good. I want to terminate any treatment’ or ‘I want you to do everything possible until ‘x’ happens.’
“Not many people have this in place when they are entering a facility.”
Advance care planning is for everyone 18 and older, Barbier said. The system is adding facilitators to walk people through the process and provided the necessary documents for people who are ready to take the step. In Louisiana, living wills and medical power of attorney documents are legally valid with two witnesses and do not need to be notarized. If someone writes his or her own will, the entire document must be hand-written by the person, signed and dated.
Although the Louisiana Secretary of State’s office has a living will registry, the Franciscan health system is going to start its own registry both of living wills and power of attorney assignments so health professionals can access these more quickly, Barbier said.
Selecting someone as the health care power of attorney requires a lot of thought, Barbier said. Many married adults choose their spouse for that role, and that’s fine, but it’s worth considering someone else who will be able to remain calm in a necessarily emotional situation.
In Barbier’s case, that is a friend rather than her husband.
“I said, ‘Don’t be offended, but I wasn’t going to put you as my health care power of attorney. Could you make a decision if something happened to me right now? There is nothing in place and you’re in this emotional state,’” she said. “He looked at it from a different perspective: ‘I don’t know if I would be able to make that decision when I’m emotionally distraught.’”
Steps to Advance Care Planning
Tips from Our Lady of the Lake Regional Medical Center
1. Identify and document someone to have your health care power of attorney.
2. Reflect on your values and beliefs and determine what “living well” means to you.
3. Consider any cultural, religious, spiritual or personal beliefs that might influence your decisions.
4. Reflect on and document your choices for healthcare.
5. Make your documents legal by signing them and having two witnesses sign.
6. Share your decisions with the person you grant health care power of attorney.