When you die, do you want your loved ones to feel like they let you down when you needed them most?
Sadly, many feel this way when caring for a loved one who can no longer communicate, but who never made their wishes clear when they could. It’s the ultimate regret, and it’s entirely avoidable.
Tim Boon is an RN and the CEO of a Good Shepherd Community Care, a Boston-based hospice and palliative care non-profit. He flew all the way from the East Coast to lend his wisdom about end-of-life planning. He also performs the most amazing Dr. Seuss homage on medical decision making you will ever hear. Please: have the conversation with your surrogate decision maker TODAY. CHECK OUT TIM’S ENTIRE POEM IN THE “LYRICS” TAB BELOW!
And here’s just the poem, with subtitles!
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When Something Has Happened We’d All Prefer Not: My Advance Directives In case of a Sudden Life Threatening Event by Tim Boon RN
Dear family and friends and whom it may concern
I’m writing this poem to help you discern
The actions to take and the things to refuse
When some terrible day you are faced with the news
That some sudden illness or stroke of bad luck
Has left me unconscious and helpless and stuck
face-up in an ER,
laid out on a stretcher
With chaos around and you’re under pressure
To make some very quick, high-stakes decision
I want you to feel you at least have a vision
Of what you can do, so you’ll know in your soul
That you’ve done what you could with what’s in your control.
There are so many things that could happen to me
From a normal disease to some strange tragedy
I could be shot,
Stabbed or bombed by a
crazed mass attacker
Or do something as simple as choke on a cracker
If I was much older or already quite sick
I’d review what I do and I don’t want right quick
But while in what I think is a good state of health
(barring malignancies lurking in stealth)
It’s a bit more complex than would otherwise be
Were I now gravely ill and you were my trustee
If I suffered already some known bad condition
Like terminal cancer for which a physician
Had given a very poor,
sad, short prognosis
Like a bile duct tumor or gliomatosis,
PPMS or an end-stage cirrhosis
I’d choose my own plan for my own diagnosis.
If my heart
to give out
and I knew it
I’d save you this trouble and write my way through it
I’d sit down with my Doc, if she’d sit down with me
And we’d write out the orders for all docs to see
It would be what in most states is known as a POLST form
In our Commonwealth we call it a MOLST form
We’d talk about tubes for food and hydration
For breathing and peeing and resuscitation
She’d find out when I’d want to be hospitalized
And without much ado it would be finalized
After all of my preferences I have confided
And my doc has checked off all the things we’ve decided
About what I do and I don’t want provided
We’d print out both pages, one sheet, double-sided.
We’d sign with a pen, in blue or black ink
And the paper would be Astrobright’s® Pulsar Pink™
But that’s not how it is, nor how it may be
When someday you stand looking down sadly at me
When something has happened we’d all prefer not
When I’m mauled by a bear
or a nasty blood clot
Has wedged its way into my heart or my brain
And my pulse or my breathing I cannot maintain
Without all the people, machines and the meds
In this room with us now with the Clinitron® beds
At this point you’re proxy, and I am unable
To speak or to write because I am unstable
What I advise now is you try to keep steady
They’ll understand here that nobody’s ready
to see what you’ll see and to hear what they’ll say
You’ll need to stay strong to get through this day.
In these first hours, before they know much
There’s no need to talk about hospice and such
I’d like pretty much everything under the sun
To keep me alive till assessments are done
But that’s where it gets hard, those assessments are key
To know well exactly what’s happening to me
You’ll remember, dear Julie, from your nursing classes,
And know things are bad when they mention blood gases.
When they work fast, but talk to you slow as molasses
To tell you my PCO2 count surpasses
The level at which any life can sustain
And they’ve just placed a catheter in a large vein
And they tell you inserting a tube down my throat
And pumping in air is the best antidote
To whatever initial tests tell them assails me
Let them do it but know
that it won’t cure what ails me
Keep in mind
all the time,
that there’s really no doubt
That whatever’s put in
we can make them pull out.
If its Day Two or Day Three and there’s been no real changes
If we’ve not gotten past keeping vitals in ranges
That keep me alive and my organs perfused
And my mental state’s worse than just simply confused
And I’m still not able to talk, think or write
It’s time to get serious bout how long to fight
Now’s when you’ll have to deal with the odds and the chances
And get all the intel on my circumstances
Make sure all the docs are real honest with you
And they’ve given a total and thorough review
That will help make it clear
what you think
I would do
If there’s a good chance I’ll emerge from this coma
With nothing so bad as a limp or a stoma
Then tell them to go ahead with their bad selves
and flitter around me like magical elves.
And poke me and prod me and turn me about
And shove in more tubes from my tail to my snout.
But it must be a GOOD chance,
don’t take a long shot
To find out for sure, get a palliative consult
You’ll want a clinician who’s skilled in the art
And who’s taken the time to review my whole chart
You need him or her to be truthful with you
To share data and odds and to talk the thing through.
So, review all the facts,
don’t get too sentimental
Save that for the funeral,
I won’t be judgmental
If the life that I’ve lived is now fully behind me
That’s what I want, in the end, to define me.
I don’t want the mem-ory of me recalled
As an oblivious lump with devices installed
And I damn sure don’t want all the money I’ve saved
To be spent on my trip from this bed to that grave
I’d rather you have it,
the kids and their spouses
If Bernie had won it could help them buy houses
Because he did not and they’re gonna need knowledge
You can set it aside to help them with college
But I guess I’ve digressed,
that stuff’s all in my Will
Let’s get back on the track and get you up this hill.
If the odds don’t look good, please don’t grasp at faint straws
Tell my kids, friends and mother — and my in-laws
To gather and for just a moment take pause
Tell me you love me and give me a kiss
Have them turn off the things that buzz, whirl and hiss
Have the nurse give me meds to make sure I feel good
And pull the tubes out, knowing it’s understood
That you were first rate
in a tough situation
You have only my love and my firm affirmation
And my trust you’ve performed, as in past situations,
In a way that’s exceeded my best expectations.
Oh, One last thing………………………..
Before you commence your official bereavement
Could you see if the hospital has an agreement
To do Hospice Inpatient- at my bedside?
It’s just, .. if it got around that I died
And wasn’t on hospice, I’d be quite mortified.
By Timothy Boon