A Star on the Calendar
Planning for the upcoming COVID-19 holiday season? A personal reflection about one of the best “gifts” you can give to the people in your life.
It has been said that COVID-19 will change the world permanently. The pandemic is having a profound effect on every aspect of the lives of Canadians. More recently, the news has been highlighting the impact of the second wave of COVID-19 on vulnerable populations and those that live in congregate settings. But COVID-19 can infect people of all ages and health can change in an instant and without warning.
This became personal for me about a month ago. I received a call from my mother after she was visiting my Dad, who now lives in Long term care. She had been there as his essential caregiver and recognized that something was “off.” I could tell she was worried. Two days later, the Director of Care notified us that there was a resident on his unit who had tested positive for COVID-19 - the first in the home. The outbreak protocols had been put into place and all residents were being tested. I could feel my heart sink. Two days later my mother had a fever and was unable to taste and smell.
Their test results came 4 days apart and confirmed my fears, they were both positive. A large outbreak was declared and with both parents at high risk, I knew their probability for severe illness and even death was significant. I put a star on my calendar and started counting the days. Knowing the typical progression of COVID-19, each day was filled with apprehension while waiting for updates.
As a physician, I have been involved since the beginning of the pandemic with long term care homes in COVID-19 outbreak discussing goals and direction of care with patients, if capable, or their Substitute Decision Maker(s). However, now my role had changed. I was no longer the physician but the worried family member. Fortunately, I had already discussed and understood my parents wishes and values with respect to their health care. If their conditions deteriorated, the health care team would need to know: Would my Dad want transfer to a hospital? Would my mother want intubation in an ICU? If difficult decisions needed to be made, I felt prepared to speak on their behalf. It was one of the only comforts that I had during those early uncertain days.
Two weeks passed and thankfully they both recovered .... the most difficult decisions did not have to be made – this time.
With the end of the year approaching, we all want to spend time over the holidays with our loved ones. But this year, except for household members, our conversations will be by telephone or video with hopes that next year we can celebrate in person. This holiday season, Advance Care Planning Canada is encouraging us to share with our families what brings us JOY. Advance care planning is not about how we want to die, but how we want to live and sharing what matters most.
In my opinion, these conversations are one of the best gifts that you can give your family. If you haven’t already, please consider reaching out to your loved ones about their wishes, values and beliefs, i.e., what makes life worth living for them? Then, if they become ill, you can have comfort in knowing you can be their voice if called upon.
The best time to plan for future healthcare choices is before a medical crisis occurs and COVID-19 has given us a reminder of the importance of these conversations. So, pour a warm drink, have a festive treat, and start the conversation!
Happy Holidays!
For resources to help guide the discussion:
Advance Care Planning Canada
https://www.advancecareplanning.ca/
Plan Well Guide
Dr. Amanda Adams is a Family and Palliative care physician in Markham Ontario. She volunteers as a Regional Champion with Hospice Palliative Care Ontario in the Health Care Consent and Advance Care Planning Community of Practice.
