In the time of COVID-19, our health can change suddenly and without any warning.
If you became seriously ill from COVID-19,
- would your family, caregivers and healthcare providers know how you would want to be cared for?
- who would speak for you if you were too ill to speak for yourself?
Start planning for your care now.
Information You Need To Know
Before You Start Planning
- Most people with COVID-19 recover on their own while self-isolating at home.
- A small number of people become sick enough to need care in a hospital. A few of them become seriously ill and may be admitted to hospital intensive care (ICU).
- Older adults and people with existing medical conditions are more likely to become seriously ill with COVID-19 and have a higher risk of dying.
There is currently no cure for COVID-19.
The goal of treatment is to give your body the chance to fight the virus.
Admission to ICU allows for care and treatments that are not available elsewhere in a hospital, including:
- Constant care and close supervision by specialized health-care providers.
- Treatments that may save a person’s life
- A breathing tube connected to a breathing machine (a ventilator).
- Cardiopulmonary Resuscitation (CPR) if the person stops breathing or their heart
- Memory problems, concentration problems, emotional changes.
- Trouble performing simple tasks such as cooking, cleaning, making phone calls.
- Permanent lung damage from being on a ventilator for a long period of time.
- People seriously ill with COVID-19 find it difficult to breathe on their own.
- A ventilator pushes air through a tube directly into a person’s lungs.
- The ventilator may keep them alive long enough for their body to fight the disease
- Most people seriously ill with COVID-19 who are put on a ventilator do not survive.
- Those who survive may never return to their previous health.
- The longer people are on a ventilator the more likely they are to have a poor outcome or die.
CPR is an emergency procedure used if you stop breathing or your heart stops beating. It can include:
- Pressing forcefully on your chest and possibly breathing into your mouth.
- Electrical shock and drugs to try and start your heart.
- Very few people of all ages survive CPR in hospital.
- CPR can cause injuries, such as broken ribs or bruised lungs.
- People who survive CPR often need a ventilator afterwards.
- About half of the people who survive CPR are left with brain damage and ongoing serious health issues.
- People who were mostly healthy before becoming seriously ill with COVID-19.
- Those who only need a ventilator for a short time (days or a week or two).
- Those who have heart, lung, liver, or kidney failure.
- Those who have a terminal illness, such as advanced cancer or advanced dementia.
- Those who are older or very frail.
Start Planning Now
Follow These Steps
- What makes each day worthwhile for you?
- What gives your life meaning, joy and purpose?
- What cultural or spiritual beliefs are important to you?
- Do you have any chronic health conditions such as diabetes, heart, lung, or kidney
- Are you over the age of 65?
- Do you have an autoimmune disease or a weakened immune system from a medical condition or treatment, such as chemotherapy?
If you answer yes to any of these questions, you are at higher risk for developing severe illness from COVID-19.
It is important that you discuss your health care wishes with your doctor.
- Think of abilities such as getting dressed, toileting, feeding, walking, hearing, vision, talking with family and friends, driving, and managing your finances.
- What abilities would you be willing to give up in order to prolong your life?
After treatment in an intensive care unit (ICU), people may experience problems with some of these abilities.
Some of these life-support treatments have been needed by people critically ill with COVID-19:
- Admission to hospital intensive care unit (ICU).
- A breathing tube connected to a ventilator.
- Cardiopulmonary Resuscitation (CPR).
Whatever options you choose, your health-care team will do their best to control your symptoms and make you comfortable.
Whatever location you choose – your home, seniors’ care home, or hospital —you will always receive care and treatments to control your pain, manage your breathing and keep you comfortable.
Choose someone who:
- You trust to make decisions that honour your wishes and instructions.
- Is calm in a crisis and able to handle conflict.
Ask them if they will accept this responsibility.
You can complete a Representation Agreement Section 9 form to legally name them to speak on your behalf (this person is called your representative).
- Make a time to talk with your Representative and family members. You can start the conversation by saying:
“I’m not sick right now, but I want to share with you what matters most to me and how I would want to be cared for if I get very sick from COVID-19.”
- Book a time with your doctor or nurse practitioner to talk about your priorities and wishes for care if you get very sick from COVID-19.
How you can let others know about your wishes:
- Write down your wishes clearly, or record them using a phone or computer.
- Complete a Representation Agreement Section 9 form to legally name someone as your Representative(s). You do not need a lawyer or notary to complete it.
- Talk to your doctor if there are specific treatments you would refuse, they may recommend a form for you to complete.
A Representation Agreement Section 9 form is available online through the BC government.
Nidus Personal Planning Resource Centre provides basic forms and custom forms for representation agreement forms.
First responders know to check on or near the fridge for health-care planning documents.
Consider giving your Representative, family and your health-care providers a copy of these documents.
- Your thoughts on any of this might change over time or if you become ill.
- You can always change your mind at any time.
Disclaimer: This guide was based on clinical studies and the experience of healthcare professionals. The information is intended to help individuals and families talk about what care they would want should they become seriously ill with COVID-19. This information does not replace medical advice from doctors or nurse practitioners. It is strongly recommended that people speak to their healthcare providers about their care wishes and topics presented here.