The Chaos Faced in the Emergency RoomShe arrived by ambulance. Stable but critical, status post-CPR, on a ventilator, orders to transfer to ICU. The ER Unit clerk informs you there are nearly 20 people in the waiting room. The ER doctor met with them briefly.  The news was grim. Grandmama is not doing well. Now you have to inform them of the transfer to ICU and what to expect.   

You ask for immediate family – TEN people get up and follow you. Yes, they are all her children. In a quiet waiting area, you ask if anyone has a POA? No. Does she have a Living Will? No. Advanced Directive? No. Who makes decisions for her normally? Five people raise their hand – then three more go up. Someone asks “Is she going to die?“

You explain she is being transferred to ICU. She is stable for now with the ventilator helping her breath. The room erupts in chaos. “She doesn’t want to be on machines.” “That’s not true.” “I don’t want to see her all hooked up to machines.” “She has a will.” Angry voices – a few shouts – security comes to stand nearby. You think of how this could have been avoided. Should have been avoided. 

At some point, this family needed to discuss the inevitable time when Grandmama – staunch matron of the family – would not be able to voice her opinions or wants. Who will speak for her? Make the hard decisions? 

Power of Attorney for Healthcare

A Power of Attorney (POA) allows the appointment of someone to make health, legal and/or financial decisions for you in the event you are unable to speak for yourself. For healthcare concerns, a POA for Healthcare will give the designated person the authority to make medical decisions. They can confer with the family, listen to advice but will eventually make decisions as to what does or does not get done for Grandmama. 

The POA should be prepared long before arriving in the Emergency Room of a hospital. They are written so that the transfer of responsibility occurs at a designated time or when the “principal” (writer of the POA) becomes incapacitated. Until that point, the principal continues to make their own decisions. Now, unfortunately, Grandmama cannot speak for herself. There is no one in charge. Being the eldest, smartest, pushiest doesn’t put you in charge.  Each child has an equal say in Grandmama’s care. 

So here we are. How will ten distraught children of this obviously much-loved woman ever agree on major healthcare concerns?

What have you done to prevent a situation like this in your family? You don’t have to be elderly to become incapacitated either. An illness, an accident – anything can happen. This may be a great opportunity to take action.