Some years ago, I took my then 83-year-old mother to the ER for a severe allergic reaction that caused her lips and tongue to swell so enormously I thought her airways would become blocked. It was July, when the new interns and residents start.
One of them gave my mother a shot of epinephrine - a powerful adrenaline medication that’s known to bring down swelling, but could put her at serious risk. Epinephrine punches up the heart rate, something my mother, with her poorly functioning heart valve, could not afford.
Any effect on her heart would have occurred quickly, so when nothing bad happened, I relaxed.
But then, I saw the newbie about to administer round two.
I started screaming, threatening at 2 a.m. to call the chief resident, while dialing my mother’s cardiologist. I told them I simply would not let them do it. I shouted that I would sign a waiver. And I, who never stepped foot in medical school, started mouthing off about what to administer instead. Whatever it took. I was incorrigible.
And then, probably fed up, they stopped.
Why do we do it? Why do we caregivers insist, plead, and pour ourselves into the plight of the ones we love? Watching them in distress is often harder than enduring it ourselves. We are nearly biologically driven to do something to make their suffering stop.
Even if we go slightly off the rails in the process.
Well, there’s a way to channel that instinct so instead of ranting, you can negotiate calmly in the face of a medical crisis.
It boils down to paperwork.
You should have the elderly or seriously sick person in your life sign what’s called a “living will.” This is a legal document that spells out what care they want if they become too ill or incapacitated to make their wishes clear. And if you can have a conversation around the signing, even better — later on, you’ll be able to advocate with more sensitivity and understanding.
Doctors also struggle with what they call ‘triad’ encounters - where everyone is weighing in and doctors don’t know who the rightful decision-maker is. Have your loved one sign a healthcare proxy, depending on your state, also called a health care power of attorney. These authorize someone — maybe you — to be the official voice in the room.
Another important doc to line up is a do-not-resuscitate order - a DNR. It comes down to one question: if the heart or breathing stops, do they want CPR?
Here’s some motivation to get it done. You don’t need a lawyer for any of this. Living wills and health care proxies usually require witnesses — sometimes a notary, and most states provide the forms to fill out. A DNR is not a legal document; it’s a medical order that can be as simple as one line in a hospital chart.
That night in the ER, I realized what a close call we had. I started the paperwork a few days later. Those documents will definitely help, but calm — well, that's still a work in progress.
Janice M. Horowitz covered health for Time magazine for more than two decades; she created and hosted the public radio segment, Dueling Docs: The Cure to Contradictory Medicine. She is the author of "Health Your Self: What's Really Driving Your Care and How to Take Charge."
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