A colleague of mine, Lex Frieden, recently told me he nearly died of pneumonia in January after first contracting the flu.
“Thank goodness my wife overruled my do not resuscitate orders,” he said.
In his advanced health directive, he had designated his wife, Joyce, as the person who would make his health decisions for him if he were unable to do so.
Frieden ended up in an intensive care unit and on a ventilator to assist with his breathing.
As the COVID-19 pandemic continues to spread, Frieden believes it may be a good time for people to review their advance directive and make necessary changes — especially for those most vulnerable to the novel coronavirus.
“Some of us don’t know exactly what we said when we did our advance health instructions years ago,” he said.
Do not resuscitate orders are written instructions telling health care providers not to preform cardiopulmonary resuscitation when a person has no pulse or is not breathing.
Frieden, 71, is a professor of biomedical informatics at the University of Texas Health Science Center at Houston and directs the Independent Living Research Utilization Program at TIRR Memorial Hermann, a rehabilitation hospital in Houston. He had a high spinal cord injury when he was a freshman in college, resulting in quadriplegia.
According to research, flu can be especially hard for people with spinal cord injuries, especially if paralysis limits the muscles that support lung capacity and volume, making it more difficult to exchange oxygen in the body.
The New Mexico Medical Orders for Scope of Treatment form has options to choose or reject a medical intervention and hospitalization, and to designate someone to make health care decisions.
A useful online guide for making medical decisions for another person was published by the American Bar Association’s Commission on Law and Aging.
According to the guide, health agents must understand the patient’s wishes and if possible make sure the doctor describes the risks and benefits of each proposed intervention prior making a health decision.
Art Schreiber, 92, said he canceled his DNR order when he was asked by a doctor with the Veterans Affairs hospital in Albuquerque prior to an emergency treatment for a blood clot last summer.
Schreiber is the author of a 2014 book, Out of Sight: Blind and Doing All Right, and worked in radio and journalism.
He lives at La Vida Llena, a retirement community in Albuquerque that has had a deadly outbreak of COVID-19. Dozens of employees and residents of the community have contracted the virus, and least 17 residents have died from COVID-19 complications. “I’m lucky they moved me a week prior to the outbreak to a temporary building across town while they were completing a construction project,” Schreiber said.
He said the care he has received at La Vida Llena has been very good.
I was told by one employee of the facility, who asked to remain anonymous, that almost all of the residents at La Vida Llena had DNR orders, and many had DNH, or “do not transfer to the hospital” orders on file.
These orders do not mean “do not treat,” the worker said.
Many of the COVID-related deaths in New Mexico have been people over 70, and more than 40 percent of them were residents of nursing homes and other long-term care residential facilities.
According to various reports, more than 10,000 coronavirus-linked fatalities in the U.S. have been residents of long-term care facilities.
Andy Winnegar has spent his career in rehabilitation and is based in Santa Fe as a training associate for the Southwest ADA Center. He can be reached at email@example.com.