It is an unprecedented time as healthcare professionals adjust to the rapidly changing landscape created by COVID-19. Hospitals and medical staff are trying to manage the demands created by the influx of patients and shortages of supplies. Nursing home populations and older adults, often with underlying chronic medical conditions, are the highest risk of being affected by COVID-19. Many will get sick, some critically, and many will die.
Anxiety is common due to the uncertainty as it’s impossible to plan for everything. But, life’s unknowns can be better managed by talking openly, especially about what matters most and what kind of care an individual would want most if he/she were to become seriously ill with coronavirus. If it isn’t said, they won’t know. Caregivers may need to make decisions, whether they’ve been told what is or what is not wanted. Don’t assume it is known. Open conversations can pave a way to clarity, provide comfort and bring people together.
All adults should have an advance directive to identify a surrogate decision-maker and provide information about treatments they may or may not want in an emergency. However, for frail elders and patients at risk for a life-threatening clinical event, a POLST (Practitioners Order for Life Sustaining Treatment) form is appropriate.
POLST is a medical order and directs doctors by providing specific instructions related to a patient’s personal goals of care, artificial nutrition, resuscitation and re-hospitalization. Dr. David Barile, Founder and Medical Director of The Goals of Care Coalition of New Jersey (GOCCNJ) states, “I strongly encourage family decision-makers and authorized healthcare proxies for people living in nursing homes or other long-term care facilities to speak with their loved ones, when possible, to make decisions about future medical care, and to put them in writing.”
GOCCNJ is helping to educate the elderly, nursing home residents, their loved ones, and their authorized healthcare proxies about the importance of discussing and documenting wishes for medical care in either an advance directive or POLST. Once a month during April 2020, GOCCNJ led daily, 30-minute Zoom webinars. Here is a recording of one of these events.
Access free tools and resources about COVID-19 and the advance care planning process:
“Now is the time for individuals to take an active role in their health by making decisions about future medical care. Please, help medical staff offer heroic interventions to those who wish to have it, so they don’t burden those who wish to avoid it,” implores Dr. Barile.
GOCCNJ is a 501(c)(3) nonprofit organization and the only network of organizations in NJ working together to make certain that patients with serious illness get the care they need and no less, and the care they want and no more. Through education and advocacy, GOCCNJ’s mission is to ensure that healthcare providers, patients, and family caregivers have the information, resources, training, and tools they need to facilitate discussions that result in a care plan that aligns treatment with the patient’s goals of care.