“Don’t wait until you’re in a crisis to come up with a crisis plan.” Phil McGraw
It was perfect Arizona weather: seventy degrees and sunny, a great day for the Model Train Collectors Association annual picnic. It’s held in Scottsdale at the McCormick-Stillman Railroad Park, on 30 acres of prime land, once part of a large Arabian Horse and Angus Cattle ranch owned by a grandson of John D. Rockefeller. The public park offers train rides, museums, an interactive “luxury” Pulman Presidential train car, games, and family fun. In another building, numerous model train layouts entertain kids and adults alike.
What could possibly go wrong on such a gorgeous day?
The picnic offered every kind of food you would expect at one of these events. Hot dogs, hamburgers, and sausages, all cooked on a grill with delicious aromas wafting through the air. People (ahem, wives, and girlfriends) brought delicious side dishes of potato and macaroni salads, baked beans, and deviled eggs. There were so many enticing desserts that it was difficult to choose. What could possibly go wrong on such a gorgeous day?
My husband and I (he in his train engineer’s hat with its many buttons indicating his love for model trains) had just settled down with plates of food when I looked up and saw the grill man, grey-faced, tottering, and about to pass out. His wife sat him in the shade as a few buddies offered water and a cold cloth while someone called 911. An EMT crew from Scottsdale arrived within 5 minutes. An efficient and experienced team tended to the man, took his vitals, and gave him oxygen. He was in “the pink” within minutes of their arrival. Phew! This could have quickly gone the other way, with him in the ambulance, drugs, and resuscitation paddles at the ready.
If her husband was incapacitated, she could make healthcare decisions on his behalf, and she knew what he wanted, including NO CPR.
After the dust settled and the EMTs enjoyed the BBQ lunch (at everyone’s insistence), I asked his wife if he was doing OK. She said he had some heart issues in the past, but for now, he was doing fine. She said she was his Medical Decisions Power-of-Attorney, as they are called in Arizona. If her husband was incapacitated, she could make healthcare decisions on his behalf, and she knew what he wanted, including NO CPR.
But what if she wasn’t there that day? I asked the EMT boss what they would do if they needed to resuscitate him. The EMT said they would make the decisions they thought would be in his best interest. They did not know him, so they had no idea about his treatment wishes or what would be in his best interest. He was in his late eighties, in poor health, and CPR in older adults like him often had a bad outcome. The force of the procedure typically causes broken ribs or, worse, brain damage. They would have done the opposite of his “best interests.”
Resuscitated, Nancy Cruzan was on life support for nearly EIGHT YEARS while her parents fought to disconnect her feeding tube.
Luckily, today, they did not have to resort to such drastic treatment because it wasn’t necessary. Even if it was, this couple was among the rare group (about 28%) who put their end-of-life planning in place and had conversations about what to do in a crisis. In 1983, twenty-five-year-old Nancy Cruzan was driving home from work on a January night when she lost control of her car and was thrown face-down into a water-filled ditch. Resuscitated, Nancy was on life support for nearly EIGHT YEARS while her parents fought to disconnect her feeding tube. She had no advance directive (AD) or surrogate; her crisis shined a light on the need for ADs.
Don’t leave your end-of-life decisions in the hands of the fickle fates, requiring your family, like Nancy Cruzan’s, to pick up the pieces.
A crisis due to a medical event or accident can happen at any moment, so every adult over eighteen should create a crisis plan in the form of an AD and choose an effective healthcare surrogate. Record a video on your phone stating your name, date, and EOL wishes and goals. It’s used for backup if there are any questions or family conflicts about what you want when you can’t speak for yourself. Have “the conversation” about medical and EOL wishes with your surrogate, family, and healthcare providers. Keep your AD updated and accessible to ensure your last wishes are honored. Don’t leave your end-of-life decisions in the hands of the fickle fates, requiring your family, like Nancy Cruzan’s, to pick up the pieces.
Althea Halchuck, EJD, CT, BCPA
For guidance, call 978-618-7150
