The surgery had gone well, but there were major complications afterward. The patient had developed pneumonia, then kidney failure, and then delirium and profound weakness. Now she was ventilator-dependent and required intravenous medications to keep her blood pressure stable. Her expression was dull and lifeless. She hadn’t been home for over three months. Her condition was “critically ill, but stable.”
According to Dr. Lamas, there are about 100,000 chronically critically ill patients in the United States at any one time. Since the population is aging and medical technologies are improving, this number is only expected to grow. The clinical outcomes of these patients are extremely poor. Half of the chronically critically ill will die within a year, and only around 10 percent will ever return to independent life at home.
Dr. Lamas describes the dilemma of these patients and their families. In the early stages of critical illness, the choices seem simple. It is the choice between life and death in an emergency. However, the chronically critically ill are in a lingering uncertain “in-between” state that often lasts for months and ends poorly.
This article reminded me of my own experiences with patients and clients in similar situations. This is one reason why estate planning focuses on being prepared for medical incapacity. Review your estate plan to ensure that it reflects your wishes, and discuss your preferences with your family.