Let’s talk about creating an advance directive in Colorado during COVID-19.

How to have family conversations

Advance Directives in Colorado are imperative documents, also called a living will, that let your medical team know how you would like to be treated in medical situations. They also state personal wishes for end-of-life health preferences.

As of today, 1 in 49 Coloradoans has been diagnosed with COVID-19. And one-third of Coloradoans are 65 or older. That means that more than ever, it is important to stay home and social distance, AND prepare your advance directive with a COVID clause if you are 65+.

Let’s walk through the basics of advance directives and COVID-19, and we will share how to change your advance directive in Colorado with your family and well being in mind. 

What is an advance directive?

According to UC Health, “Also known as a living will, an advance directive is a legal document that lets your healthcare team know your preferences for the medical care you would want to receive in the future.”

It’s good to note that an Advance Directive is not the same as a financial will.

Also, no lawyer is needed to complete your advance directive – all that is required for it to be legal is your signature and two witnesses’ signatures.

How does COVID change my advance directive?

COVID-19 has changed our world in previously unimaginable ways in 2020. From social distancing and not seeing loved ones to the looming stress of potential respiratory illness, COVID-19 arriving has marked a large shift in the healthcare field (and the world).

What are Common Care Treatments for COVID-19

COVID-19 treatments range with the severity of the situation. They can be as simple as staying home with flu-like symptoms to full ICU treatment. OF course, we can all hope we will be lucky enough only to show flu-like symptoms, or solely lose our taste and smell if diagnosed with COVID-19, but that may not be the case, so it’s good to know the next steps.

General care for COVID-19 that is non-emergent but still necessitates a hospital stay includes antiviral drugs, anti-inflammatory medications, and antibodies.

ICU treatment occurs if the patient is seriously ill and is usually lung related due to COVID-19 attacking lung functionality. ICU interventions may include a breathing tube and mechanical ventilator. It’s noted that these interventions supply seven times the volume of the oxygen we get from breathing normally.

In this case, it’s best to consider your feelings about receiving a breathing tube and ventilator. Also, it’s time to consider other extraordinary measures, such as cardiopulmonary resuscitation (CPR).

This is where a cardiopulmonary resuscitation (CPR) directive comes into play. A CPR is another part of your advance directive and is a medical order, and it instructs providers not to resuscitate if a person’s heart or breathing stops.

This type of advance directive generally applies to the seriously ill and should be discussed at length with your loved ones. Then you and your doctor must sign this form.

The National Institute on Aging recommends that all adults have at least a medical durable power of attorney in place in a CPR directive.

How should I change my advance directive?

We suggest adding a COVID-19 addendum. This special addendum will mark the specific kind of care you want if you contract COVID-19 and are hospitalized.

Questions to consider are:

• If your oxygen levels are dropping, do you want to go to the hospital, or would you prefer to get noninvasive respiratory care at home? 
• If you cannot receive noninvasive respiratory care at home, do you want to go to the hospital? 
• If the care available to you at home can keep you comfortable but cannot save your life, is your preference to stay at home? Or do you want to go to the hospital? 
• When you get to the hospital, do you want healthcare providers to only treat you with noninvasive options that could save your life (such as oxygen through a face mask or nasal mask)? Do you want them to do anything necessary to keep you comfortable and control your symptoms? Or do you want to be put on a ventilator if that becomes necessary to save your life? 
• If your heart stops, do you want to be resuscitated via CPR?
• If you would like to be ventilated, are there any guidelines around how long you want to stay on the ventilator? Is there a length of time that you wish to remain on the ventilator? Days? Weeks? Months
• Do you want your healthcare proxy to have the ability to override any of these orders if he or she believes you have a reasonable chance of living a life consistent with your values and priorities based on the information provided by the doctor? Or, do you want these orders followed no matter what?
• Do you want to be kept out of physical pain with the help of opioids, or would you like to opt-out?
• Do you want any tests whose results would be meaningless, given the potential desire to avoid treatments that might be burdensome, agitating, painful, or prolonging your life or death?

These are just some of the questions we think are important to consider when thinking about a COVID-19 advance care directive and addendum.

Who can help me with my advance directive in Colorado?

How do I talk to my family about my advance directive and COVID-19?

As always, we encourage talking to your loved ones openly and calmly about your needs and wishes. Here at Vintage, we offer our Ombudsman services to guide you through moments like these. You can find resources by contacting the Long-Term Care Ombudsman for Region 12 at 970-513-2980 or tstrang@nwccog.org

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