Coronavirus and advance directive planning: what experts say you need to know

During the COVID-19 pandemic, medical emergencies can arise quickly.

Although it's a difficult topic to discuss, wishes for end-of-life care are an important conversation to have with family and loved ones before a medical crisis occurs. Written instructions for the treatment you would like to receive in the event you cannot speak for yourself, called advance directives, are paramount.

Advance directives are crucial during a medical emergency. If you were to become ill and hospitalized, it is the hospital's duty to sustain your life, regardless of the chance of recovery, the ability to pay for services, or the emotional toll on family and loved ones. By having advance directives established, you can ensure your wishes regarding end-of-life care are acknowledged and fulfilled by medical staff.

While it's important to talk with family and loved ones regarding end-of-life care, it's also important to have your wishes documented as part of advance directives. A key component of advance directives is the durable power of attorney for health care, which allows you to establish a patient advocate to speak on your behalf if you are incapacitated. By establishing your advance directives, you are ensuring your wishes are known and acknowledged and your patient advocate, family and loved ones understand your wishes as well.  

A patient advocate should be someone whom you have already discussed your health care wishes with, who is willing to ask questions of attending health professionals and can withstand the pressure of making difficult decisions. This person is responsible for making decisions regarding care, custody, and medical and mental health treatment. This may include employing and discharging medical staff, consent or withdrawal of treatment, or even arranging care at home or in a nursing home. Having your wishes documented will help ensure your patient advocate understands the medical and mental health treatment you wish to receive.

This person does not have to be a family member; they can be a trusted friend, minister, rabbi or priest. Whomever you choose as your patient advocate, it should be someone you trust to carry out your wishes in your advance directives.

Once you have completed your advance directives and named a patient advocate, he or she will sign the acceptance form, indicating he or she will make decisions on your behalf and act in your best interests should you become incapacitated. When creating advance directives, it is also good practice to have a second advocate named in the event your first patient advocate is unable to act on your behalf. 

How to prepare

 When completing your advance directives, do your research and understand what treatments you want and do not want, and any concerns you may have. During the COVID-19 outbreak it is important to reflect on the care you want in case you become ill. Some instances to consider: If you are ill and your illness worsens, do you wish to be hospitalized or would you want to receive care at home? If you are hospitalized, do you want aggressive life-saving measures even if they offers the risk of decreased quality of life? If you stop breathing, do you want to be resuscitated? These are cases you should take your time to consider and discuss with your patient advocate, family and loved ones.

Deciding which treatments and the extent of treatment you would like to receive can be difficult. For support or help making those decisions, it may be helpful to speak to your family physician, minister, rabbi, priest, counselor or a close friend. In the instance you become incapacitated, your advance directives will ensure your wishes are known, eliminating any unnecessary stress on you, your patient advocate, family and loved ones.

Advance directives are a legal document, can be created free of charge and do not require an attorney. They can also easily be submitted to a statewide registry so physicians have access to these documents. Once established, you should provide a copy of your advance directives to your family members and your primary physician, and keep a copy for yourself. Advance directives should be kept in an easily accessible location so they can be retrieved in case of a medical emergency. By establishing advance directives, you can ensure your family and patient advocate understand and honor your wishes regarding end-of-life care.

To request a free advance directive booklet from McLaren Health Management Group to document your end-of-life wishes, call (810) 496-8623 or email