Speak Up, Be Heard, Be Clear! by Kristine Jordan, DHA, BSN, RN, NEA-BC

In Naples, we are a community that plans well.

We build thoughtfully, invest strategically, and protect what matters. We anticipate risk, diversify portfolios, and make decisions today to safeguard tomorrow. And yet, when it comes to healthcare decisions at the most critical moments of our lives, many of the same people who plan everything leave the most personal decisions of all undefined.

Not legally. Emotionally.
I was recently involved in the care of a man in his 40s who suffered a massive, unexpected healthcare event.

One day he was working, living, making plans. The next, he was unable to speak, unable to participate in his own care, and entirely dependent on others to decide what would happen to him.

His family gathered quickly. They loved him deeply. They wanted to do the right thing. But they did not agree on what “the right thing” was. There was no roadmap, only fragments of past conversations, vague recollections, and differing interpretations of what he might have wanted. One family member insisted he would “want everything done.” Another was certain he would never want to live in a state of profound dependency. The room became tense. Emotional. Fractured.

And beneath it all was a quiet, unspoken truth:
No one actually knew.

This is where even the most prepared families become unprepared.

Because having documents is not the same as having clarity. A healthcare surrogate, power of attorney, or even a DNR can make decisions, but they cannot create certainty where none exists. They cannot replace the specificity of a conversation that never happened. And in the absence of that clarity, decisions are often made not from confidence, but from fear, guilt, or
disagreement.

Modern medicine has given us extraordinary capabilities. We can sustain life in ways that were unimaginable a generation ago.

But with that capability comes a more complicated question and one we often avoid: Just because we can, should we?

What does “quality of life” actually mean to you?
What outcomes would you accept and which would you not?

At what point does extending life no longer align with how you would want to live it? Ultimately, what matters most to you? These are not easy conversations. But they are defining ones. Because the true burden placed on families in these moments is not logistical, it is emotional. It is the weight of wondering, Did we do what they would have wanted? It is the possibility of carrying doubt long after the decisions have been made.

In the case of that man in his 40s, care moved forward. Decisions were made. But not with unity. Not with peace. And perhaps not in full alignment with what he would have chosen for himself.

His wishes were not known. And because of that, they could not truly be met.

We plan our financial legacies with precision.

But our healthcare decisions, arguably the most personal expression of our values, are often left unspoken. The most important planning you can do is not just on paper. It is in conversation. Clear. Specific. Unmistakable.

Because one day, the people who love you most may have to speak on your behalf. And what they carry into that moment will matter more than anything you ever signed.

Dr. Kristine Jordan is a board-certified nurse executive and Market Director of Admissions for a national hospice organization, where she leads clinical teams and supports patients and families through some of life’s most complex healthcare decisions. With a background spanning emergency/trauma care and executive leadership in home health, case management, and hospice, she brings both clinical expertise and a deeply human perspective to her work. She also serves as an adjunct professor and course writer in healthcare administration and nursing, focused on leadership, ethics, and patient-centered care.