Lessons on advance directions from the Pope and my mother

Many families see familiar scenarios when they see and pray Pope Francis during his current health crisis. It is not uncommon for a person with a severe illness to appear to be nearing the end of their lives to improve before they are convinced that it will be in the next decline. How many of us love someone with a chronic condition and have you thought that our next trip to the hospital might be the last? We hope to do our best and prepare for what we know. How many of us sat at the bedside of family and friends and wanted to do everything right, but felt we weren’t ready at the moment?

The best part of our human instincts inspires us to take care of our loved ones. Pope Francis’ journey reminds me of the simple things that united my mother and our family and allowed us to take care of her in the way she wanted them to.

Knowing Pope Francis, we can assume that there is peace and clarity in his situation. Given what we know about the state of the Holy Father, it is likely that his doctors have sought a clear direction regarding his preferences. They need to know who will make a decision on behalf of the Pope if he cannot speak for himself. Following what is called a “long-term respiratory crisis,” which requires high flow oxygen, they need to know what the Pope wants if that level of oxygen becomes insufficient. Should he be intubated and placed on a ventilator? If his heart stops, would he want to be revived? These questions are asked daily in hospitals across the country and around the world.

You don’t necessarily need to know how the Pope will answer. But we should get closer to our home. How do our close family and friends answer these questions?

My mother spent her entire adult life as a resident of St. Petersburg. She gave birth to three sons (I was the youngest) at St. Anthony Hospital in downtown. I have clear memories of being nine years old. He sat with her, in the palm of his hand at Pasadena Hospital, signing that she would not be resurrected for her grandfather. More recently, I have given her the care of Mees Countryside Hospital respiratory therapists who saved her life deep in the Covid pandemic. Shortly afterwards, we were sitting together in the clinic at St. Anthony (the building where she gave birth to me) when she decided it was time for a referral to the hospice.

My mother taught me a lot about how she lived in this world that brought me to me. She also taught me a lot about the meaning of dying well and preparing to God for home.

The health crisis has arrived, but the conflict has not. As a family, we wanted to do the right thing for her. Two things were needed for this to happen. We needed to know what she wanted and needed help to make it happen. Her pre-orders told me what she wanted. Professional care from clinicians at Baycare and Empath Hospice gave my mother and us what we needed. Her last day was spent in our family’s living room. She was in the exact same place that she rocked her three sons with her toddler. We ate together, watched a movie together, prayed together. I admit, those “goodnight prayers” were some of the most powerful things I have experienced.

Most people have well-formed ideas about what a good ending looks like, but they often keep that idea secret because they feel that timing never talks about it.

After working for 25 years at one of the nation’s leading advance care planning organizations, many people can tell them that they are motivated to complete advance directives if there are practical examples of the kinds of decisions they need to make. It can be spurred by the death of a loved one, the conspiracy line of movements and television shows, or the example of public figures such as the Pope.

Sometimes they are inspired by the beauty they observe and want the same thing. They convey their preferences about the people they want to visit, expressions of love and forgiveness that are recognized or requested, the music they want to hear, or how they want to remember. Conversely, some people are motivated by, as they faced the last day, they wanted to avoid, or were part of, the chaos and conflict they witnessed. They do not want children to split up about treatment choices or feel the weight of decision-making without guidance.

My mother and Pope Francis are both examples of peace in the midst of a health crisis, where hope can be possible in the face of despair, and joy can be found even in times of sorrow.

You can follow this path, but perform an action on all parts. When we see the news about Pope Francis, we all have the opportunity to look at those we love and ask… “What would you like to do if you were in the Pope’s shoes?”

Paul Malley is president of Aging With Dignity, a nonprofit based in Tallahassee, and created the Five Wishes Advance Directive. www.fivewishes.org