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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

Today’s tip is about advanced care plans in intensive care, and also the absence of an advanced care plan and how you need to use either for your advantage or for your critically loved one’s advantage.

So let’s just quickly start, what is an advanced care plan? Now an advanced care plan is, if somebody is documenting a living will that if they go to intensive care if they’re critically ill, what they would want to have happen?

So for example, do they want to have all options exhausted for life support under no circumstances should the ICU team withdraw life support? Or on the other end of the spectrum, if somebody goes into ICU, do they want minimal intervention? And they fear that if they were to survive a critical illness that they might end up disabled and dependent on other people. And if they don’t want that, then the ICU team is allowed to stop treatment, or at least minimize treatment and see where that leads.

So let me illustrate that with an example of a client that we are currently working with. So, we have a client who is 58 years of age, had a cardiac arrest, he’s in ICU and had a hypoxic brain injury because they had a prolonged period of time with no oxygen to the brain. So therefore the client is not in a position to make a decision about his or her fate going into the future.

The ICU team is adamant that treatment should be withdrawn and that nature should take its course because they feel that the client would not have any quality of life going forward or not have a meaningful recovery. There is no documented advanced care plan. However, the family- the wife, son and daughter are adamant that their dad would want to live at all cost irrespective of what the quality of life looks like in the future.

They’re happy to take the “burden to live with the uncertainty” of whether their loved one is surviving, and what their quality of life is going to look like if they do survive. And what that means in terms of, does their father or husband need 24-hour nursing care? Are they going to be dependent on other people? Can they interact meaningfully with other people? And so forth.

The ICU team then made that argument that they do not want to burden the family with the decision-making process around what should happen next for their loved one. And again, the ICU team said that, they do not want to put the burden on the family to stop life support.

And in the absence of an advanced care plan, the ICU team doesn’t even need to go down that track because the family is very happy to take responsibility and the ICU team does not put any burden on the eyes of the family as well. The only burden the ICU team is putting on the family is that they are trying to force them to agree to basically stopping life support and letting their loved one die.

And we made the argument to the ICU team, which is a very valid argument that in the absence of a documented advanced care plan, the family is not worried about taking the burden of responsibility and saying, “Yup, we want a tracheostomy for our father so he can live. And we can see whether he can recover down the line and can have some form of meaningful life and quality of life at home or maybe even in a nursing home.” It doesn’t matter.

Quality of life is very subjective. It can’t be measured in objective terms. And again, the family is not worried about the burden of making decisions. That is not an argument the intensive care team can use. Most families are actually very happy to make decisions and live with the consequences.

So that is my quick tip for today. Do not be discouraged as a family in ICU to make decisions and ask for that decision-making authority. You can decide for yourself whether you want to live with any consequences of your decisions. You are an informed adult and you’re informing yourself about consequences, and then you should proceed as you think is the right thing to do for your critically ill loved one.

That is my tip for today.

This is Patrik Hutzel from intensivecarehotline.com. If you have a loved one in intensive care, check out our website, intensivecarehotline.com. Call us on one of the numbers on the top of the website if you have a loved one in intensive care.

Like this video, comment down below what questions that you have and subscribe to my YouTube channel for updates for families in intensive care.

This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.