In your advance directive, you can put No. 1, do not resuscitate, and No. 2, call Betsy. She is my health-care proxy. You’ve talked to Betsy. You talked to her every year at Thanksgiving and you update her about what you want.
Wells: I imagine a lot of people don’t have advance directives because it’s uncomfortable to think about and talk about.
Banach: Absolutely. But the thing that we’re seeing now with COVID-19 is that what once seemed so far away is close to home for a lot of people, especially if you’re in a place like New York. I want this to be an impetus for people having this conversation.
Wells: How do you have this conversation? How do you bring it up with Betsy at Thanksgiving?
Banach: If it’s your parents, for example, you say, “Look, hey, Dad, if something goes wrong, who do you want to make a decision? If you don’t empower me or someone else to make the decision, then the government or the institution is going to make the decision.”
Hamblin: And then he says, “I’m going to be fine. Everything’s okay. Don’t worry about me. Pass the gravy.”
Banach: “Yeah. But you know what? Here’s the deal. It’s not about you. Because you know what? You’re not aware at that point. It’s about me and it’s about Mom. And it’s about, you know, brother two and brother three. We’re going to end up fighting with each other over what your wishes are.”
Unless you really want your whole family to fall apart, as sometimes happens, you’re going to have this conversation. What you’re doing is letting people off the hook. You’re saying very clearly, “This is who I am; this is what I want.” Take out your smartphone. Do a video selfie. Say, “My name is Edo Banach. These are my wishes.” So if it ever gets to a debate over what I wanted or didn’t want, that’s clear.
Hamblin: The main issue is that we don’t want to have this conversation, especially right now, when people are genuinely scared and alone and you’re calling them on the phone sounding like the harbinger of death. Is there a resource where people have scripts for how to approach this conversation?
Banach: There are a couple. Our website has a decision guide for COVID-19, and it also has resources for how to have a conversation about advance-care planning in general. There is also a group called the Conversation Project, which aims to facilitate these kinds of conversations. Generally speaking, social workers are better at having these kinds of conversations than physicians, doctors, nurses, or lawyers. If you have any questions, those are always good resources.
Wells: I don’t have an advance directive. I don’t know anything about any of my family members and wishes. In my case, the issue is not that I think my parents would not be open to the conversation. For all I know, they have advance directives. The issue is that I don’t want to have that conversation, because it means acknowledging that they will die at some point. Any advice?