Planning for the worst

Sunday, April 16, is National Healthcare Decision Day, and many national, state and community organizations are highlighting the importance of advance healthcare decision-making, aiding people’s ease of mind when wondering if their needs will be met in a life-threatening situation. In Sauk Centre, the Light the Legacy organization is offering education on advance healthcare directives though free monthly classes.

“It’s something we do in a lot of different communities, and this is brand new for Sauk Centre,” said Lynn MacKenzie, Light the Legacy executive director.

The sessions will be held at First Lutheran Church in Sauk Centre from 1-2 p.m. on the fourth Wednesday of every month, with the first one scheduled for April 26. No appointment is necessary, but people are encouraged to arrive at 1 p.m. Online Zoom sessions will also be available during the day and the evening for those who cannot attend in-person.

Janell Hoffman, a Faith Community nurse certified by CentraCare Health-St. Cloud, will be leading the classes.

“Anybody 18 years or older can go get help and should have their healthcare directive,” Hoffman said. “It’s a forward-thinking idea to have your things in order for your life, especially for young people in an emergency situation.”

During a class, attendees will have the chance to overview the advance healthcare directive forms, both the long and short versions, and learn what it takes to complete one and officiate it as a legal document. Witnesses for signatures will be available.

“CentraCare and other healthcare facilities do provide these for their patients when they come in for an annual checkup,” Hoffman said. “They hand them out, have a discussion with you and advise you on filling it out, but that’s as far as it goes because that’s how much time they have in the medical field. This (class) is a supplemental provision in the community for those who are struggling with making these decisions and trying to come to grips with it.”

The advance healthcare directive form also includes guidelines for people to consider when making their decisions, including what does and does not make life worth living.

“Those are hard questions you have to think about,” Hoffman said. “What helps you make the decision for what you want to have done for your medical needs? … My role as a volunteer is to guide people through that process and make sure they complete the paperwork. Then, it’s getting the witnesses’ signatures and getting it back to your healthcare provider and agents – the people who are going to speak for you in case you can’t speak for yourself.”

MacKenzie has had personal experience with the importance of having a healthcare directive in place. When her first husband, Bruce MacKenzie, was 39, he found out he had stage 4 lung cancer which had spread to his liver, lung, bone and brain. He underwent radiation to his back and brain, followed by 10 months of chemotherapy. For his last 32 days, he was in Fairview University Hospital in the Twin Cities.

‘He was on a ventilator. I had to make some very difficult decisions on his behalf,” MacKenzie said. “It was a Faith Community nurse who, in our early 30s, talked about this healthcare directive. We had a will – we had two young kids – but we didn’t have a healthcare directive, and when you’re faced with that diagnosis of cancer and the end stages, the last thing you want to be doing is worrying about a healthcare directive.”

MacKenzie has met and talked with many spouses who were in a situation similar to hers, some of whom feel they were responsible for their partner’s death because of the decisions they had to make.

“I don’t feel that way, because I knew when enough was enough and we’d had those conversations,” MacKenzie said. “It was sad and terrible, but (it is better) with planning in advance when you’re thinking clearly and not in the ER or ICU or in crisis.”

In MacKenzie’s experience, advance healthcare directives also proved useful during the coronavirus pandemic when people could not even get into the hospital to be with their loved ones.

April 16 was selected as National Healthcare Decision Day because it is the day after Tax Day.

“Ben Franklin said – many, many years ago – that the only things certain in life are taxes and death,” MacKenzie said.

Statistically, about a third of people who get their healthcare directive form actually complete it. One of the risks of not having a healthcare directive is ending up with someone who would not make the best decisions.

“In most hospitals, they would have a hierarchy who they would go to,” MacKenzie said. “If you haven’t appointed somebody to speak on your behalf, they would go to a parent, an adult child, a sibling, and maybe you don’t have good relationships with those people.”

Alternatively, someone could end up being hospitalized or resuscitated against their will or be given treatments they would rather not have.

“Maybe somebody says, ‘I want CPR and everything,’” Hoffman said. “That’s what’s important as well. That part gets stressed, because maybe their loved one doesn’t know they want to pull out all the stops and do whatever you can to save their life. … That’s another good reason to be informed and have it pre-planned.”

Hoffman and MacKenzie know it is not easy to make an advance healthcare directive, but it is something that could take stress off of a person’s mind later in life.

“People are so relieved after they do it,” MacKenzie said. “We’ve been doing it for over 20 years. … We’re really trying to meet individuals where they are, out in the community versus in the healthcare system. When they’re younger, they’re healthy, they’re thinking clearly, and people are so appreciative of having that resource available.”