Advance Directive
Advance Directive
An advanced directive outlines a person’s medical treatment preferences if they become unable to communicate, focusing on end-of-life care and specific medical interventions. In contrast, a healthcare power of attorney (POA) designates someone else to make healthcare decisions on their behalf under similar circumstances.
A few years before my dad passed, he had fallen and ended up in the hospital.
Sitting beside my father’s hospital bed, the harsh hospital lights and the constant beep of the machines became the backdrop to one of the most important conversations of our lives. Dad, with all his strength sapped away by illness, still had that spark in his eyes, the one that always signaled his need to understand, to know more.
“Dad, this stack of papers here, it’s called an advance directive. It’s like that healthcare POA we talked about, but it goes into more details about specific medical situations you might face and how you would want to be treated…,” I explained, trying to keep my voice steady.
Dad tried to adjust himself, a shadow of his former vitality, as he reached for the documents. I helped him sit up, making sure he was as comfortable as possible amidst the tangle of tubes and wires.
“Specific situations? What kind of situations?” he asked, his voice weak but filled with the need to understand, to be in control.
I took a deep breath, knowing the weight of what I was about to discuss. “It outlines what should be done if you’re ever in a terminal condition, Dad, or if you’re not going to wake up, or if the doctors think there’s nothing more they can do. It’s about your wishes in those times.”
He looked away for a moment, out the window, maybe trying to find solace in the sight of the world moving on outside. “With the healthcare POA, would you be the one to make these decisions?” There was a softness to his voice, a hint of vulnerability, and strong conviction that I would do right by him.
“Yes, Dad. But going through this document I will know what your wishes are, so I can do right by you and mom. We’ll go over everything, make sure it’s exactly what you want,” I assured him, squeezing his hand for emphasis.
The room was quiet for a moment. The only sound was the steady beeping of his heart monitor. This wasn’t just a legal formality; it was a moment of raw honesty between us, a preparation for what was to come.
“Let’s go through it, then,” he said, a bit more firmly. “I trust you, Rosie. Let’s make sure it’s clear.”
So we began, me reading each part of the directive, him listening intently, asking questions, or giving a small nod of agreement. We discussed the hardest things – life support, resuscitation, what dignity meant to him in the end.
“Dad, do you understand this part, about not being brought back if it’s…if it’s time?” My voice wavered as I broached the topic of Do Not Resuscitate, one of the hardest discussions.
He gave my hand a reassuring squeeze, grounding me. “I do, Rosie. And I agree. I’ve had a full life. I want to leave it with dignity, on my own terms.”
As we made our way through the document, I felt the enormity of what I was taking on. I was no longer just his daughter; I was his advocate, the one who would speak for him when he couldn’t.
We found moments of lightness, too, reminiscing about the past, using humor to ease the tension. It was our way of dealing with the dark – finding bits of light wherever we could.
When it was all done, the document signed, a kind nurse acting as a witness, a mix of relief and sorrow washed over me. We had faced one of our biggest fears head-on, together, and it had brought us even closer.
“Today is not the best day for mom, she has been sleeping for 24 hours.” Do you think we should prepare one with the same choices as yours for mom? We can explain it to her together when she has a good day.” asked Rosie with a deep sigh.
Her dad responded, “Yes, she and I have talked about these things in the past and she would like the same choices as me.”
“Thank you, Rosie, for being the strong one now,” Dad said softly, his eyes meeting mine, filled with a lifetime’s worth of love and gratitude.
I leaned in to kiss his forehead. “I love you, Dad. Whatever comes, we’re in it together.”
Walking out of that room, advance directive in hand, I knew there were tough times ahead. But having tackled this, having had this conversation, I felt a little more prepared. Whatever the future held, we had each other, and that was the most important thing.
Wanting to Stay
Jacob and Benjamin’s Story
Benjamin lay in his hospital bed, the beeping of the monitors a constant reminder of his frailty. The once robust and commanding presence now looked small and vulnerable under the crisp white sheets. His son, Jacob, sat beside him, holding his father’s hand, trying to offer some semblance of comfort.
“Jacob,” Benjamin began, his voice trembling slightly. “We need to talk about something important.”
Jacob nodded, his expression serious. “Of course, Dad. What is it?”
Benjamin took a deep breath, struggling to find the right words. “The doctors have been talking about advance directives and resuscitation orders. I need to tell you what I want, but it’s hard.”
Jacob squeezed his father’s hand. “I’m here, Dad. Whatever you need to say, I’ll listen.”
Benjamin’s eyes filled with fear. “Jacob, I don’t want to die. I’m scared. If my heart stops, I want them to do everything they can to bring me back. I need you to make sure they do that. I need you to promise me.”
Jacob’s heart ached seeing the fear in his father’s eyes. “Dad, are you sure? The doctors said resuscitation might not be the best option given your condition. It could cause more pain and suffering.”
“I know, but I’m not ready to go,” Benjamin insisted, his voice cracking. “I want every chance to keep fighting. Please, Jacob.”
Jacob felt a lump in his throat, struggling to keep his emotions in check. “Okay, Dad. I promise. I’ll make sure they do everything they can.”
The next few days were filled with discussions with doctors and hospital staff, ensuring Benjamin’s wishes were clearly documented. The advance directive was updated, specifying his desire for full resuscitation efforts.
Late one night, as Jacob sat by his father’s side, Benjamin reached out and took his hand. “Thank you, Jacob. I know it’s hard, but you’re giving me a chance. That’s all I can ask for.”
Jacob nodded, tears welling up in his eyes. “I love you, Dad. I’m also not ready for you to go.”
Weeks later, Benjamin’s condition worsened, and the inevitable happened. His heart stopped. The medical team rushed in, performing CPR and other resuscitation efforts. Jacob stood outside the room, his heart pounding, praying for a miracle.
After what felt like an eternity, the doctor came out, his expression somber. “We did everything we could, Jacob. Your father fought hard, but his heart couldn’t take it anymore.”
Jacob felt an overwhelming wave of grief crash over him, his legs nearly giving out beneath him. The doctor’s words echoed in his mind, a final confirmation of what he had dreaded most. Tears streamed down his face as he entered the room where his father lay, still and at peace.
With trembling hands, Jacob gently touched his father’s hand, feeling the coolness of his skin. He leaned in close, his voice choked with emotion. “Rest now, Dad. You were brave. I love you so much.”
Jacob stayed by his father’s side for a long time, the weight of his loss pressing down on him. He thought of the promise he had made, the nights they had spent talking about life and death, and the fear in his father’s eyes. He had done everything he could to honor his father’s wishes, even when it broke his heart.
The Struggle for Control
Ellen and Mason’s Story
Mason and Ellen had shared a lifetime of love, laughter, and memories. As they sat in Mason’s hospital room, the weight of the current situation pressed heavily upon them. Mason was now frail and fighting a relentless battle with a severe heart condition.
Ellen sat by his bedside, her hand gently resting on his. She could see the fear and sadness in his eyes, and she knew there was something important he needed to say. “Mason, what’s on your mind?” she asked softly, her voice filled with concern.
Mason took a deep breath, struggling to find the words. “Ellen, there’s something we need to talk about. It’s about my advance directive.”
Ellen’s heart tightened, but she nodded, encouraging him to continue. “I’m listening, Mason. Whatever it is, we’ll get through it together.”
He looked down at their intertwined hands, unable to meet her gaze. “I’ve been thinking a lot about what might happen if things get worse. I need you to know that if my heart stops, I don’t want to be resuscitated.”
Tears welled up in Ellen’s eyes as she processed his words. “Mason, are you sure? That’s a huge decision.”
Mason finally looked up, his eyes filled with sorrow. “I am, Ellen. The doctors said that CPR and other measures could cause more suffering. I don’t want to go through that, and I don’t want you to see me like that.”
Ellen’s tears fell freely now, but she squeezed his hand, trying to offer him strength. “I don’t want to lose you, Mason, but I understand. It’s your choice, and I respect that. I just want you to be at peace.”
Mason’s voice trembled as he spoke. “I’m so scared, Ellen. Not of dying, but of leaving you. I don’t want you to be hurt by my decision.”
Ellen moved closer, wrapping her arms around him as best she could. “Mason, your peace is what matters most to me. If this is what you want, then I’ll support you. We’ll brave this together, just like we always have.”
They held each other for a long time, their silent tears mingling as they drew strength from their bond. The conversation was difficult, but it brought them closer, allowing them to face the future with a shared understanding.
In the days that followed, Ellen worked with the doctors to ensure Mason’s wishes were documented. They updated his advance directive to include the Do Not Resuscitate (DNR) order, making sure every detail was in place.
One evening, as they sat watching the sunset from his hospital window, Mason turned to Ellen, his expression peaceful. “Thank you for understanding, Ellen. You’ve always been my rock.”
Ellen smiled through her tears, holding his hand tightly. “And you’ve always been mine, Mason. I love you more than words can say.”
As time went on, Mason’s condition worsened, but he faced each day with courage, knowing he had Ellen’s unwavering support. When the end finally came, it was peaceful, just as he had wished. Ellen was by his side, holding his hand, whispering words of love and comfort.
In the days and weeks after Mason’s passing, Ellen found solace in knowing she had honored his wishes. It didn’t lessen the pain of losing him, but it gave her a sense of peace, knowing he had been surrounded by love and understanding in his final moments. She carried his memory with her, cherishing the time they had spent together and the strength they had found in each other.