For some people, like Rita Hartung, having discussions about end-of-life care comes naturally, due to her personal nature and previous life experiences. Rita’s first husband, Wally, was diagnosed with cancer after they had been married for 22 years. This led to honest conversations about the types of care both he and Rita wanted to receive. Included in these talks were their daughters, Maureen and Patti, who were teenagers at the time. When Wally died in 1984, the family was confident his wishes had been honored.
Five years later, Rita married Lawrence Hartung. They lived happily together for 24 years before Lawrence passed away while in hospice care in 2013. Lawrence previously completed a simple, standardized medical order form to communicate his preferences for key life-sustaining treatments. With this in place, Lawrence’s end-of-life care went according to his plan as well.
Taking note of the importance of making wishes known and having a guiding document in place, Rita began taking steps to develop her own formal plan. She first established her daughter, Maureen, as her power of attorney. She later completed her own medical order form. In the two-sided, one page, bright orange document, she laid out her preferences for things such as CPR, general scope of treatment, antibiotics and artificial nutrition and hydration.
“The conversation was easy and comfortable,” Maureen says. “First of all, mom was not scared of death. Her faith was a very important part of her life and where she found strength in the toughest of times. She believed her ‘ticket was punched to go to heaven.’ Furthermore, in addition to her two husbands who had passed away, all five of her siblings died before she did.”
The medical order form Rita developed with Maureen was first put into use in the hospital after she fell and broke her arm and hip. In time, she was discharged to a skilled nursing facility. In both care settings, the medical order form came with her and helped guide her care, as she alternated between recovery and periodic setbacks.
The week before Rita was scheduled to move to a long-term care facility, there was a sudden change in her condition, and she was rushed to the emergency room. She was critically ill with heart failure and perhaps kidney failure. The EMT team who transported Rita brought her medical order along. Maureen and the attending physician were able to review its key points. Still, the physician offered to admit Rita to intensive care, where they could treat her for a short time and watch for improvements.
Maureen talked with her mom and told her what was going on with her health. After learning about her condition, Rita asked Maureen, “Do they have my orange paper? I don’t want to go to intensive care.” Maureen explained how she and the physician wanted to verify Rita understood the choice she was making. “My ticket is punched,” Rita said. “I’m good to go.”
Rita was moved to inpatient hospice, where she was able to be with family, meet with a chaplain and pray the Rosary, all of which were important to her. She passed away less than 12 hours later, very comfortably, in a way true to her wishes.
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