The Importance of an Advance Directive
It was early one evening, after an already long day and long week, when I got the call that my dad had been transported to the hospital with shortness of breath, chest pains, and was barely conscious and not able to respond to questions. I dropped everything, kissed my lovely wife good night, and headed off for an hour drive to the Mercy Methodist Hospital in South Sacramento.
When I arrived I was directed upstairs to the ICU. I had a very uneasy feeling that I was going to meet my father for the last time on this planet. I’m usually very comfortable in hospitals as my home care business has me visiting clients in acute care all the time, and helping them set up home care once they are discharged from the hospital. And so I was surprised at how uneasy I felt this time as I checked in and the front desk. My voice even cracked a little as I told them I was looking for Charles Philbrick and that I was his son. I remember sending out a post to my friends on Facebook that I suspected my dad had taken his “last ride.”
When I entered the room my dad was laying there with his eyes closed, his hand on his chest. When I said hi to him he opened his eyes a little as said my name with a little surprise in his voice. It had been too long since I had visited him and he wasn’t expecting me. He managed to get out a question: “what was the name of that place with the planes?” “El Mirage” I responded, referring to the glider port he had taken us to as a teen ager and we both learned to fly sailplanes.
That was the last thing he ever said to me, even though we were together constantly for the next three days. The floor physician and charge nurse came to see me when they found out the next of kin had arrived. They explained how gravely ill he was, and that lifesaving measures would simply prolong his suffering. Then they asked the problematic question: “Does your dad have an advance directive?” I honestly didn’t know, and so I called his conservator. He didn’t know either, but had a note that was thirteen years old from my mom telling someone that he always wanted to be kept alive if at all possible. The conservator had to err on the side of legal caution and so told the team at Mercy that my dad was “full Code:” they had to do everything possible to try to keep him alive.
This began three days of me being forced to watch as my dad suffered through one painful and invasive procedure after another. He could only respond to questions by tapping on his chest, but was able to moan in deep pain as these procedures had to be done with minimal anesthesia to keep from killing him.
I begged the doctors and the conservator to put him on “comfort care” and let him spend his last hours or days without pain. But because of the lack of a clear Advanced Directive authorizing the hospital to do this, his suffering was drawn out much longer than it needed to be.
Finally after multiple conferences, and several sleepless days, the hospital honored my request in writing with my conservators blessing, and took my dad off of life support and began administering the comforting end of life treatment that allowed him to rest peacefully. It was only a few hours after that when he passed away, and my dad was gone.
We counsel families every day on the importance of completing this essential document for the end of life wishes of their senior family members, and yet I was remiss in securing this basic and simple document for my own dad.
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