Capturing the Wishes


Capturing the Wishes

wishing-well-76869_640On Tuesday morning, I woke up grateful that Monday was over.

Until my mom called mid-morning with an update. "My hemoglobin dropped a little bit," she said.

And so did my heart.

Her hemoglobin drops when she starts bleeding. We just moved her back to the community hospital from the university hospital and endured nothing less than a battle between the siblings about where my mom should be. Two siblings wanted my mom to remain at the university hospital, which has a longer scope to detect internal bleeding, in case she begins to bleed again. Another sibling and I wanted her moved back to the community hospital.

I started to worry that we had a huge problem on our hands until I reminded myself: Every worry needs a plan.

I decided we needed to document my mom's wishes about her care. I texted a sibling who I knew would be visiting my mom at the same time as my dad that afternoon. I explained my idea: Let's talk about what Mom wants going forward so we can avoid future fights.

Before I headed to the hospital, I double checked my mom's durable power of attorney for health care decisions. My dad steps in to make decisions when my mom can't. If my mom and my dad both cannot make decisions, I step in. Another sibling steps in to make my mom's medical decisions if my mom, my dad and I can't.

When I arrived at the hospital, I asked my mom if she would be okay discussing her wishes in case she begins to bleed again. She agreed. So, with my dad, a sibling, the sibling's spouse and I, my mom shared her thoughts about her future care. (The sibling present was not one of my mom's medical powers of attorney.)

If our mom begins to bleed again:

1. She wants the doctors at the community hospital to do everything they can so she can remain at the community hospital.

2. If she requires an intervention not available at the community hospital, she wants to be transferred to a downtown hospital which also has a longer scope.

I asked her about the university hospital where she just spend the weekend in a few different ways: If the university hospital has the only treatment that can help, would you want to be transferred back? If the university hospital has the only treatment that can save your life, would you want to be transferred back?

Her answer to both questions was "No."

We also discussed a process to ensure my mom makes informed decisions going forward. She will discuss decisions with
her medical powers of attorney, who will act as her sounding board that she uses before she makes any final decision.

I emailed the details of my mom's wishes to all the siblings the next day. We'll continue to have these discussions with my parents as their situations change.

Thankfully, the drop in my mom's hemoglobin was just a dip; her number increased the next day. She continues to be stable and we're now working on her discharge to rehab.