No matter where you fall on the political spectrum, you undoubtedly mourned the recent loss of one of America’s First Ladies. In death, as was the case in life, Barbara Bush has unobtrusively influenced the American consciousness. Throughout her lifetime, her influence could be felt in the men she helped form. In death, that influence can be found in a very personal and private decision that was made public because of who she was and the public’s desire to know. The former First Lady made the choice to seek “comfort care” only in her final days, a choice that has ignited a national debate on the topic of end of life medical care. With the issue on the American agenda, now is a good time to make sure your own wishes will be honored at the end of your life by updating your estate plan.
Former First Lady Barbara Bush
You would be hard-pressed to find a woman who has had more influence on American politics and government over the last century than Barbara Bush, yet she never held office herself. Her husband, George Bush, served as a Congressman from Texas, and Ambassador to the United Nations, and Director of Central Intelligence before becoming Ronald Reagan’s running mate in the 1980 Presidential election. After Reagan’s win, Barbara served as the nation’s “Second Lady” from 1981-1988. When her husband was subsequently sworn in as President in 1989, Barbara ascended to the role of First Lady. Barbara is also the mother of George W. Bush, Governor of Texas from 1995-2000 and the nation’s 43rd President, serving from 2001-2009, as well the mother of Jeb Bush, Governor of Florida from 1999-2007.
The Former First Lady’s Last Days
The former First Lady passed away at her home in Houston on April 18, 2018, at the age of 92. She had been suffering from congestive heart failure and chronic obstructive pulmonary disease for some time prior to her death, according to family spokesman Jim McGrath. A family spokesperson also announced that Bush had made the decision “not to seek additional medical treatment and will focus on comfort care.” The former First Lady’s decision caused a media frenzy as “experts” and advocates fought for the spotlight. It also came amid a national effort to define and document patients’ wishes, and consider alternatives, before they are placed on what has been described as a “conveyor belt” of costly medical interventions aimed at prolonging life. Bush’s announcement brought the very personal issue of end of life medical care out of the proverbial closet and into the spotlight.
“It makes perfectly good sense at her age, with her failing health, that she would say at some point, ‘Life’s been good, and while you always want more, it’s enough,’” said Dr. Joanne Lynn, director of the program to improve elder care at Altarum Institute. Lynn worked with Barbara Bush years ago, when she was a congressional spouse volunteering at the Washington Home for chronically ill patients. Bush helped with the founding of the hospice program there. “We have so few examples in visible leadership positions” of public figures promoting palliative care, she said.
Defining “Comfort Care”
What exactly does “comfort care” include and exclude? Dr. Haider Warraich, a fellow in cardiovascular medicine at Duke University Medical Center and author of the book “Modern Death,” also applauded the Bush family for putting the phrase “comfort care” into the public sphere so that other people can consider it “a viable option at the end of life.” He added, however, that the statement also creates confusion about the meaning of “comfort care,” by suggesting that it entails stopping medical treatment. “Comfort care” usually refers to palliative care, which focuses on managing patients’ symptoms to keep them comfortable and retain their dignity, Warraich said. “One of the common myths about palliative care is that they are being denied medical help,” Warraich said. For heart failure patients, he said, “comfort care” usually means opting not to use a breathing machine or CPR. But patients do continue to receive medical treatment, including morphine to ease shortness of breath, and diuretics to remove excess fluid from their lungs, he said. “By bringing this into the sphere of discussion,” Warraich said, “we can start thinking about comfort and palliation long before they are in the clutches of death.”
Making Sure Your Wishes Are Honored
The only way to be certain your choices, beliefs, and wishes regarding end of life medical treatment will be honored is to incorporate advanced directives into your estate plan. In the State of Arizona, a Health Care Power of Attorney lets you name an adult, called your Agent, to make decisions about your health care, including full power to give or refuse consent to all medical, surgical, hospital and related health care. You may also decide to execute an Arizona Living Will which allows you to make important decisions about treatment you do, or do not, consent to in the event you are unable to provide consent at some point in the future because you have a terminal condition, are in an irreversible coma, or are in a persistent vegetative state. Both of these advance directives are legally binding and can be legally enforced if necessary.
Contact an Arizona Estate Planning Attorney
For more information, please join us for an upcoming FREE seminar. If you have additional questions or concerns about ensuring that your end of life wishes are honored, contact the experienced estate planning attorneys at Morris Hall PLLC by calling 888-222-1328 to schedule your appointment today.