My husband was recently hospitalized for what now looks like a minor illness. He has a number of medical problems and is taking a lot of pills. I felt a sense of panic while he was in the emergency room and was afraid that he was going to die. What can I do to better prepare for these situations?
A: The situation that you describe is very common and will become only more so as the population in the US continues to age. The tension is especially significant for older couples and the single elderly who either have had no children, or for those whose children are not living in close proximity. It is not unusual for an illness or other unexpected problem to strike with stunning force. Without any advance planning, it can be difficult to make decisions in the face of complex information interwoven with fear and grief.
As a physician under these circumstances, the discovery and processing of what appears to be new information for family members or other important friends can hinder effective communication and decision-making. On the other hand, dealing with family members or other supporters who have a good understanding of the illness and of the wishes of their loved one can lead to well-formulated choices that stand the test of time. Appropriate decisions during emergency situations can result in dividends of peace and comfort when the patient, family and friends later reflect on the events.
This kind of discussion may best lend itself to times when the family is assembled for other reasons such as birthdays, anniversaries or holiday gatherings. It’s best if the discussion is initiated by the older adult whose health is at issue. There should be some notice that this activity is going to occur. Have a list of all medications, allergies, medical conditions, any significant surgical procedures, a copy of any advance directives, and the names and phone numbers of treating physicians available on a laminated sheet. Add to this the name of the designated decision-maker.
Even though this process may sound depressing, it can be a liberating process – and one that lends a special intimacy with a collective realization of the fragility and temporary nature of life.
