Real Intentions for Life

Advance Care Tools for Caregivers


As Ryan sat at his desk, it seemed like any other workday — until he felt a sudden wave of pressure in his chest. He took a couple of deep breaths, hoping it would pass, but the pain began to radiate into his left arm. Just 45 years old and slightly overweight, Ryan wondered if he could be having a heart attack. He didn’t want to overreact, nor was he eager to have his day disrupted.

Five minutes passed. The pain was unrelenting. He told his boss he was going to the emergency department to be evaluated. He arrived safely and an EKG was performed at triage. He was rushed to a room and told he was having a heart attack. Ryan seemed shocked and felt shaky — destabilized by this unexpected crisis.

Emergency staff swarmed into his room to start IV lines and administer pain medication and aspirin while the physician explained that preparations were underway for him to go the Cardiac Cath Lab. A cardiologist would run a catheter from his groin into his heart and inject dye into his heart arteries. Once the blockage was identified, a stent would be placed to restore blood flow to the region of Ryan’s heart that was compromised. Ryan felt degraded; he struggled to accept his vulnerability and the reality of his mortality.

After the procedure, Ryan was admitted to the ICU in critical-but-stable condition. He felt his life had been destroyed with this heart attack. He could no longer brag about being in good shape and enjoying excellent health.

With similar tactics to disrupt, destabilize, degrade and destroy, a life-threatening illness presents as an act of terror — an awakening for both patient and caregiver. The caregiver can either engage the fear or counter the terror.

The following advance care tools will help caregivers combat fear and promote recovery:

  1. Fight Disruption with Composure

Anxiety acts as a disruptive force; fueling the release of adrenaline while creating a state of panic and helplessness. Your best defense against this powerful force is to keep telling yourself to keep calm. Remind yourself to take deep breaths or count to 10. Exhale with the force to blow out a flame or soothe a burn. This is not new information, but it’s another opportunity to apply this tactic to a new situation.

Life-threatening situations call for rapid responses. Your goal is not to accelerate your heart rate, but to keep your wits about you. How rapidly can you lower your heart rate, focus your mind, and return to a steady state of composure? Is this something you practice daily and carry in your virtual toolbox?

Disruption often leads to poor decision-making. If you’re off your game and lack self-control, you could falter. You reach the top of your game through the starting point of composure. Making rational medical decisions depends upon your ability to listen and be reasonable. You need to quiet your mind so you are able to be attentive and understand the information provided by the physician and nurses.

  1. Fight Destabilization with Competence

The best tool a caregiver has at his or her disposal is the ability to maintain self-control. Your demonstration of competence becomes a stabilizing force for your loved one. Competence is more a skill than the feeling that you know everything. Learning to appear competent helps you to “fake it till you make it,” gaining confidence as you help stabilize the situation.

Competence is believing in yourself. This core ability allows you to proclaim, “I’ve got this! I have my footing and know how to proceed!” This belief system isn’t innate; it’s an acquired skill. By applying discipline to shaky situations, you learn how to find balance through strengthening your core muscles.   Stabilization, as a type of muscle memory, needs to practice through physical exercises that teach this principle.

“Steady as she goes” is a nautical tool to keep a ship on track. Medical decisions require caregivers to take the helm until their patients become stable. You can imagine turning over the ship to your patient once he or she reestablishes competence.

  1. Fight Degrading through Upgrading

Upsets occur through the lack of commitment. Terror exists when walls come tumbling down. As your loved one collapses with a life-threatening illness, your immediate reaction is to prop him or her up. You raise patients’ spirits and lower stress through providing them this type of “upgrade.” An upgrade clearly reflects your level of commitment to your patient’s well-being.

Your patient needs to know that you have his back … that you are there to catch him when he falls and to act as a type of safety net and springboard. As a gift to caregivers, Michele Obama left this indelible remark: “When they go low, we go high.” This statement of commitment is a powerful tool that serves to lift the heart of your loved one.

Patients tend to feel inferior to others. Caregivers have the power to treat them as loved ones. Believing that love cures all becomes the best medicine for your patient. Acts of love such as flattery, gifts, physical touch and time together will give your patient the feeling of having been upgraded and provides a much-needed boost to his or her ego during the catastrophic event or illness.

  1. Fight Destruction with Restoration

“What doesn’t kill you makes your stronger.” Make this phrase a motto for you personally while caring for your loved one in the aftermath of a life-threatening event. It’s the starting point from which to brush yourself off, move forward and rebuild. Caregivers need to act as leaders in the process of healing and restoration.

Spiritual restoration occurs through the elements of earth, air, water or fire. These energy sources are often used to help those who experience loss or grief. They are also associated with particular Zodiac signs:

Water signs: Cancer, Scorpio and Pisces

Fire signs: Aries, Leo and Sagittarius

Earth signs: Taurus, Virgo and Capricorn

Air signs: Gemini, Libra and Aquarius

Identify and connect with the best qualities of your zodiac sign. These driving forces can be the best advance care tools necessary for you caregiver to rise above the ruin. Your patient’s healing potential can be boosted by using his or her zodiac sign as a source of innate power.


Any life-threating event is followed by a new dawn and awakening. Advance care tools allow caregivers to welcome the new day as the new normal. Your strength of character will be tested during these moments. Your ability to rise to the occasion makes all the difference in your patient’s ability to heal and recover.

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