Rethinking Living Wills - to Ventilate or Not?

To ventilate or not to ventilate? That is the burning question for many people who are revisiting their personal Living Wills during Covid-19. The heavy reliance on ventilators as an answer to respiratory symptoms are causing some to reconsider the pros and cons of allowing intubation to sustain life. What are the risks of being hooked up and what are the quality of life measurements on the other side?

A recent article in the Kaiser Health News by contributing columnist Judith Graham gives voice to those who are struggling with the question. The range of responses includes active seniors who feel that the technological intervention is worth a shot for a few more years of life and others who see the effects of an artificial breathing apparatus to be damaging to the point of being off the table of options. This is especially true of individuals responsible for their own care who hope to avoid any kind of extended assisted living.

Data on the outcomes of ventilator use retrieved from around the world and hospitals in the U.S. is still spotty and hard to interpret. However, the evidence points to more favorable results for those in more robust health. There is also general agreement that longer intubation does translate into longer and more difficult rehabilitations. Unfortunately, older adults treated for Covid-19 tend to remain on ventilators for more extended periods than younger patients, increasing their risk for negative effects.

Now is a key time to reconsider your Advanced Directives to family and loved ones. Dr. Rebecca Sudore, a professor of medicine at UCSF explains the importance of these considerations: “Some people may say my life is always worth living no matter what type of serious illness or disability I have; on the other end of the spectrum, some people may feel there are health situations or experiences that would be so hard that life would not be worth living.”

If you are thinking about these issues and need some tools to move forward, Dr. Sudore has been part of a team that has developed a website, “Prepare for Your Care,” to guide people through conversations and considerations around Advanced Directives. This tool is an excellent lead in to a meeting with a reliable attorney who can make necessary adjustments and ensure that you create a viable Living Will that reflects your true wishes.

https://khn.org/news/no-intubation-seniors-fearful-of-covid-19-are-changing-their-living-wills/