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. 2020 Sep 22;60(6):e5–e9. doi: 10.1016/j.jpainsymman.2020.09.021

Table 1.

Proposed Title Classification of Phone Calls to the Center During the COVID-19 Pandemic

Topic Number of Voice Mails Received Representative Comment
Confirmation of documents in the registry 97
  • … I wanted to make sure you got them (forms) so that everything can be in the Registry if I, God forbid, end up going to the hospital

  • Topic summary: Updating demographic information on the registry; confirming that the most current forms are on the registry

Urgent desire to initiate advance care planning 12
  • I want to get (an advance directive) filled out for my (spouse), because (spouse) needs one too.

  • I have a (advance directive or medical order) with you. It was created back in 2014, and I would like to update that.

  • I would also like to register my (spouse's) name.

  • Topic summary: Requesting new blank forms to be mailed for completion; phone discussions on how to complete advance directives; questions about advance directive and/or medical order reciprocity across states

Request for temporary rescindment of treatment-limiting forms 6
  • If I should be hospitalized because of this virus (COVID-19), I understand … they might refuse me care for resuscitation. If this is true, then I would like to cancel my (DNR) until this epidemic gets over

  • I (would) want to be put on a vent [sic] (for COVID-19)

  • Topic summary: Desire to temporarily cancel forms to ensure full treatment options are available for COVID-19

Patient-specific questions about how to honor a patient's wishes in advance directives and medical orders in light of their COVID-19 status 3
  • Case summary: The MPOA representative for a patient in a long-term care facility is the patient's only living child by blood. The patient's family, including 5 of the 7 grandchildren, were concerned that the MPOA representative may no longer have decision-making capacity due to neurological issues following a stroke. The patient had previously requested to be DNR status, which was documented. The MPOA representative changed the DNR status and indicated that the patient should receive CPR. The majority of the family believes this change is inconsistent with the patient's wishes and that the change was made or influenced by the MPOA representative's spouse instead of the MPOA representative. The MPOA representative's spouse has been acting as the MPOA representative during this time, which is not in accordance with the patient's MPOA form. Due to COVID-19, none of the concerned family members are able to visit the MPOA representative to determine decision-making capacity. No one is able to visit the patient, whom has rapidly declining health, due to COVID-19 as well.

Other/irrelevant 23
  • Topic summary: No message; wrong number; death notice

COVID-19 = coronavirus disease 2019; DNR = do not resuscitate; MPOA = Medical Power of Attorney.