Project Prepare encourages everyone to make medical wishes known

John Harch of Project Prepare

The following is the first in a series of columns written by John Harch and contributed by Project Prepare, a local group that is encouraging people to discuss and write down their medical wishes in order to avoid family conflict and unwanted medical interventions. Group members are John Harch, Jane Cohn, Patti Miller, Kristine Neel (director of Mercy Hospice), Sherie Ambrose (VP of Patient Care Services at Mercy Medical Center Mt. Shasta) and coordinator Hannah Helms. Project Prepare has been making presentations to community groups and plans to make more in the future.


Arnold is a 79-year-old man who lives alone since the death of his wife three years ago. He suffers a heart attack while mowing his lawn, and is taken to the hospital. Because of his heart problem and his long-standing emphysema, he isn’t breathing well, so doctors insert a breathing tube and put him on a ventilator in the intensive care unit.

Arnold’s daughter, Ellen, who lives 30 minutes away, is summoned to the hospital. Arnold’s son, Tim, lives in Nevada and can’t travel immediately.

Over the next few days, Arnold develops kidney failure and has another small heart attack. Since he still can’t breathe on his own, doctors are unable to take him off the ventilator and must consider a tracheostomy (a hole cut in the lower neck to accommodate a longer-term breathing tube). He is too sedated and sick to have a conversation with doctors about his treatment.

Ellen has spoken to the doctors each day about her father’s condition, which is worsening. She is trying to guide them on how much treatment to offer him, but she never had a discussion with her father regarding what he would want, and he has never filled out any papers to define his wishes.

Tim, who hasn’t gotten along with his father for the past ten years and hasn’t seen him for three years, finally arrives at the hospital. The doctors have arranged a meeting with Ellen and Tim because Arnold has developed more complications. He now has pneumonia and soon may need kidney dialysis. Ellen states that she thinks her dad wouldn’t want the ventilator, tracheostomy, or kidney dialysis. She has watched him get poked, prodded, and suctioned for six days, and thinks he is suffering. Tim, however, insists that everything the doctors can possibly think of should be done to prolong his father’s life. Tim says they should just give more pain medicine if Arnold is uncomfortable.

Since Arnold never designated which family member should make decisions for him, the doctors don’t know how to proceed.

This story is made up, but reflects many cases that have occurred over the years. To prevent something similar from happening to you, fill out an advanced health care directive that identifies who will make medical decisions for you if you become incapacitated. And please fill out a POLST (Physician Orders for Life-Sustaining Treatment) form that clearly spells out how much treatment you would want and for how long if you end up severely ill like Arnold.

Project Prepare is an organized effort to encourage people to complete these forms. Trained personnel are available to meet with you to help you understand the forms if you haven’t filled them out with your doctor. The service is free. If you would like more information or help with these forms, call Patti Miller at 926-7160 or John Harch at 859-2454.