Who Will Speak For You?

By Dr. Sharon Kelly-West –

April is Health Decisions Month

If you are in a medical crisis and are unable to speak for yourself due to the critical nature of the illness, who will speak for you from a place of knowledge?

Some state their adult children will know, some say their spouse or partner will know. Much of this is perception, as most people have not had these conversations with anyone.

Questions

•   Should your heart stop beating, do you desire Cardiopulmonary resuscitation (CPR)?
•   If a feeding tube is suggested at any point, is this what you desire?
•   If the injury is very severe requiring a ventilator or breathing machine, is this what you prefer?
•   If so, do you desire to be on a breathing machine for a certain number of days, and if no improvement, what next?

Best Practices

The preference is to designate someone (healthcare agent) you trust who will listen and follow through on your wishes for medical decision-making. It is also wise to designate a secondary agent in the event your primary healthcare agent is not available. An agent can be someone other than your spouse or sibling or child; must be age 18 or older; and cannot be receiving payment for medical care being provided you.

Once a health care agent is identified, involve them as you decide your wishes. This is an opportunity for them to also decide if this is a responsibility they’re willing to accept. If not, you can select someone else who is willing.

Advance Care Directives

Advance Care Directives (ACDs) are avenues by which care can be designated in writing by way of a living will and/or a health care agent—a person you designate to speak for you to state your preferences for medical treatment.

A mere 25% of African Americans have completed these documents. In fact, African Americans are 50% less likely to complete these directives than white Americans. Though racially and ethnically, no one group has significantly made this the priority it ought to be, I would like to challenge you to take this action step to “have your say.”

Why is an ACD Important?

The historic cases necessitating medical decision making were young ladies in their twenties: Karen Quinlan, Nancy Cruzan, and Terri Schiavo (Terri had a cardiac arrest at age 26, though we first heard of this case in 2005 when she was 41).

None of these ladies had an advance directive sharing their preferences, nor did they designate a voice to speak for them prior to the medical crisis that was cast upon them. Just think about, and remember, the chaos these families experienced when attempting to make medical decisions not knowing their preferences.

I reflect back on January 2015. My sole sibling experienced a fatal heart attack. When I received the phone call of his sudden death, time stood still for me. Though an advance directive was not needed for this situation, what if the heart attack he experienced had not been immediately fatal? What if he had remained alive yet unresponsive, and with a risk of being permanently unconscious or brain damaged, unable to participate in any of his care decisions?

We did not have those discussions. My brother was healthy, an avid tennis player, only 59 and raising his then 16-year-old son, when his heart fatally attacked him.

Early Planning Makes A Difference

Because of the potential suddenness of these medical crises, please take note that it is important to have these discussions while you and or your loved ones can communicate preferences. As the young ladies I mentioned demonstrated, this is not just a conversation for those age 50 and over.

There are many ways in this area of WNC to obtain Advance Care Planning help: Four Seasons Hospice; Care Partners Hospice; and the local hospitals. You can also download the form to review at www.sosnc.gov/documents/forms/advance_healthcare_directives/advance_directive_for_a_natural_death.pdf.

Learn more

In April, a gathering of pastors will host the first of three free information sessions: “While the Blood is Running Warm in My Veins.” The first session will offer information and an opportunity to complete advance care directives. Light refreshments will be served.

Come Join Us!

•   Saturday, April 29 – 10 a.m. – 1 p.m., Advance Care Directive Planning, Dr. Sharon West
•   Wednesday, May 31 – 6-8:30 p.m., Estate Planning, Attorney Carol Goins
•   Wednesday, June 28 – 6-8:30 p.m., Funeral Planning Guidance, various speakers

All sessions are held at Tried Stone Missionary Baptist Church, 100 Carroll Avenue in Asheville, Alfred E. Blount, Pastor.

Questions? Reach out to [email protected].