For many people, the ongoing pandemic has been a time of reflection about the fragility of life. People of all ages have been infected with the coronavirus and even some young healthy people are experiencing more severe outcomes than anticipated. Suddenly and unexpectedly, families find themselves in situations where they are trying to make end-of-life decisions for a loved one without knowing that person’s wishes.

Having documents in place that spell out medical preferences is a real gift for families in these situations. One of those documents is an advance directive, which focuses on end-of-life care preferences when doctors have agreed there is no reasonable chance of recovery for the patient. It states whether you want artificial measures (a feeding tube or a ventilator, for example) to keep you alive. In addition to completing this document, you need to choose a health care surrogate who will respect your wishes whether or not he or she agrees with them and who is familiar with your values and priorities. This person can be a spouse or other family member or a friend or colleague. It should be someone you trust who knows your medical condition and will follow through with your wishes.

Discussions about death and dying can be difficult or uncomfortable in the best of times; during a pandemic they become even more so, especially when families can’t visit loved ones in the hospital and health care workers are wearing masks that may conceal expressions of sympathy and concern or when these conversations occur on the telephone or through video calls.

For these reasons, it’s vital that everyone—regardless of age or health status—complete an advance directive, choose a health care surrogate, and discuss wishes with family members.

To help get the conversation started, ask your doctor for an advance directive form or do an online search for more information. Organizations like Aging with Dignity, a private nonprofit group that facilitates end-of-life conversations, are also helpful. Aging with Dignity crafted an accessible and understandable advance directive document called Five Wishes to help people talk about (and write down) their preferences in a neutral, life-affirming way. The Conversation Project, established by the Institute for Healthcare Improvement and associated with Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, is another helpful resource.

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COVID-19 (Coronavirus) and Neurologic Disease Resource Center