Advance Directives: Sarah’s Story

Sarah was young, in her thirties. She had been in a horrific car accident, left a quadriplegic, unable to speak or do anything for herself.

She was being kept alive by a feeding tube inserted in her nose. The liquid meals, while keeping her alive, left her more than uncomfortable.
Her place of residence was now at a long-term nursing care facility, operated by a hospital. She, like so many of us, had her own story. She didn’t have any family to speak for her. Her only way of communicating was by having a pen placed in her mouth and shuffling-out, hard-to-read scribbles.
With an attorney by her side, her day had come. She wrote her wishes, asking that her artificial feedings come to an end, her discomfort come to an end, and she be allowed to start comfort care. Sarah was of sound mind, knowingly asking that the regular feedings she received, the dichotomy of her existence, come to a halt and that she receive care to make her comfortable until she could pass. The hospital denied her wishes, and they were within their rights. If death should become imminent, even if the patient is of sound mind when making such a request, it can be denied by way of protection.
Talk to your loved ones and make your wishes known. Everyone, over the age of 18 should have their Advance Directives or Colorado Medical Orders for Scope of Treatment (MOST form) completed. This can include a Medical Durable Power of Attorney (MDPOA): this person, also known as your health agent, is able to make decisions for you, regarding your health, if you are unable to do so: guidelines for CPR, medical interventions for treatment and comfort care, full, selective or comfort focused; and information on artificially administered nutrition, long-term/permanent, short-term/temporary or no artificial nutrition by tube.
Sarah maintained that the feeding tube was placed against her will; she never wanted it, and had she known the state of which the accident would have left her, she would have been more prepared, would have made her wishes known ahead of time. The artificial feeding afforded her life. But at what costs? That’s to be determined individually. Medically, it would have added fifteen to 2o years to her life. She noted many stomach inconsistencies. She was uncomfortable.
Sarah’s case was escalated to the state Supreme Court where her wishes were granted. Her regular, artificial feedings were stopped. She was then given small increments of food, spoon feedings, by mouth and medications to make her comfortable.
It’s not my desire to place judgment on Sarah or her wishes. Only to provide comfort and support to those in need; be-it to patients with serious illnesses, family members grieving the loss of a loved one and in need of support; or quite possibly, to those who have been in a serious car wreck and seeking quality of life and wanting to be comfortable during their remaining days.

Editor’s Note: This article was written by Gina Paradiso with Sangre de Cristo Hospice & Palliative Care and may be reached at 719-542-0032.