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The Importance of Advanced Directives

By Dr. Nicholaus Mize, Estes Park Health Internal Medicine and Palliative Care Provider

What are Advance Directives? They are written instructions to medical caregivers that define what forms and levels of care a patient wants for their body, when the patient is unable to make the decisions verbally due to their underlying illness. They aid all involved to help determine how quality of life is defined by the patient. It aids loved ones and caregivers to make decisions on behalf of the patient if the underlying disease proves to provide poor quality of life. They help to define what types of care the patient would want for themselves if poor quality of life is the prognosis (the likely course of a disease or ailment).

Why are Advance Directives important? They are important because patients define quality of life differently. One patient may want full aggressive care even in the event that their underlying illness brings them to end of life. While other patients may feel that their goal of care is comfort for end of life. Some patients may be ok with being on mechanical life support for an extended period of time, while others may not want mechanical support at all.

Often physicians as professional care givers find that our patients do not have Advanced Directives, and many who have never discussed goals of care with their loved ones. In these cases, it becomes the burden of their loved ones to make difficult medical decisions for the patient. Having sound Advanced Directives in place takes this burden off our loved-one’s shoulders and guides them in respect to the patients’ rights and goals.

Why create an Advance Directives now? Everyday there is uncertainty in our lives. Most of the time it is quietly sitting in the back of our subconscious, but in our current climate, with a Pandemic that disproportionately effects specific groups of individuals, the uncertainty has moved to our conscious mind.

Anytime, and at any age in our lives is a good time to contemplate how we define Quality of Life in the face of uncertainty. Now is a good time to ask questions of your Primary Care Providers so that we may help our patients take these thoughts from contemplation and put them into instructions. If you have never considered Advanced Directives, or discussed Goals of Care with your family, please contact your Primary Care Provider (Estes Park Health Physician Clinic 970-586-2200 – please only phone calls at this time) for support and education. Now is as good a time as any to define: What are your Goals of Care when facing illness or poor Quality of Life, and how do you want to be cared for when you are facing this.

This is difficult. I know how difficult it is for many individuals to think in this manner. We may outgrow the youthful exuberance of early adulthood, and outgrow our feelings of immortality as we age. However, for many the thoughts of getting older, of developing health conditions, or of facing illness that may place us close to end of life is unthinkable. Yet, these are truths, and we need to plan to protect our individual health goals, and to help assuage the pains and burdens that family members and care providers may go through when we are unable to voice our decisions.

A tremendous resource for Advance Directives help is the Larimer Health District Advance Care Planning team at https://www.larimeradvancecare.org/. Currently the staff is working remotely, but they are still assisting clients through phone and web-based video conferencing. You can call 970-482-1909 and leave a voicemail or email them through their contact page https://www.larimeradvancecare.org/contact. You can also call or email Mindy Rickard, the project coordinator, mrickard@healthdistrict.org or 970-278-6812.