Advance Care Planning in Grand Rapids, MI: Peter’s Story

Advance care planning is important for many families in Grand Rapids, especially as loved ones age or begin to notice changes in their health. This is a local story, adapted for our West Michigan community, showing how one couple used an advance care plan to make sure medical decisions matched their values.

Early Memory Changes and Starting the Conversation

Peter and his wife, Josie, live in the Grand Rapids area. They begin to notice that Peter is having some memory problems—forgetting appointments, misplacing items, and repeating questions.

Peter remembers his own father’s experience with cognitive decline, which involved:

• Multiple hospital admissions
• Difficult behavioral changes
• Family conflict over treatment decisions

Wanting to avoid the same stress for their own family, Peter and Josie sit down together to talk about:

• What matters most to Peter in his daily life
• What kind of medical treatments he would or would not want
• How he would like to be cared for if he could no longer make decisions for himself

These conversations are an important first step in advance care planning for anyone in Grand Rapids, whether you receive care at Spectrum Health, Trinity Health Grand Rapids, Metro Health, or another local clinic.

What Matters Most to Peter

Peter tells Josie that his top priorities are:

• Staying at home with her as long as possible
• Going for regular walks in their neighborhood, even during Michigan’s cooler seasons when it’s safe to do so
• Remaining active in the garden during West Michigan’s warmer months

Based on what he saw when his father was seriously ill, Peter decides:

• He does not want cardiopulmonary resuscitation (CPR).
• If he becomes seriously ill, he does not want life-prolonging treatments, including:
  • Transfer to an intensive care unit (ICU) at a Grand Rapids hospital
  • Antibiotics intended only to prolong life when recovery is unlikely

Peter also decides that when he is nearing the end of life, he wants to receive palliative care at home in Grand Rapids, rather than being transferred back and forth to the hospital.

These preferences are written down as part of his advance care plan, sometimes called an advance directive or advance care directive.

Receiving a Dementia Diagnosis in Grand Rapids

About a year later, Peter is seen at a cognitive, dementia, and memory clinic at his local Grand Rapids hospital. This could be a specialty clinic connected with Spectrum Health or another major healthcare provider in the area.

After a full assessment, Peter is diagnosed with dementia. This diagnosis is a turning point, and it prompts Peter to:

• Review his existing advance care directive
• Update his preferences while he can still clearly express his wishes

He meets with the clinic’s neuropsychologist to:

• Confirm that his documented wishes match his current values and goals
• Clarify what kinds of treatment he would accept or decline as his dementia progresses

The neuropsychologist recommends that Peter also appoint a medical treatment decision maker (sometimes called a healthcare proxy, patient advocate, or durable power of attorney for healthcare in Michigan).

Peter Appoints His Wife as His Medical Treatment Decision Maker

Following this advice, Peter formally appoints his wife, Josie, as his medical treatment decision maker. This means that if Peter becomes unable to make or communicate his own medical decisions, Josie will:

• Speak on his behalf
• Work with doctors and nurses at local Grand Rapids hospitals and clinics
• Make choices that reflect Peter’s documented wishes and values

They complete the appropriate legal forms for Michigan and make sure:

• Copies are given to their primary care provider in Grand Rapids
• Copies are included in Peter’s hospital records
• Family members know Peter’s wishes and who his decision maker is

This step is especially important in West Michigan, where emergency situations can arise quickly—such as winter falls, infections, or complications from chronic conditions that are common in older adults.

A Health Crisis and Hospital Care in Grand Rapids

About 18 months after Peter’s dementia diagnosis, he collapses at home due to a severe chest infection. Emergency services transport him to a Grand Rapids hospital, where the treating clinician:

• Reviews his medical record
• Sees that Peter has an instructional directive (advance care directive) on file
• Recognizes that Peter has appointed Josie as his medical treatment decision maker

Because Peter is too unwell to participate in decision-making, the clinician:

• Consults with Josie
• Reviews Peter’s documented goals of care and values directive

Josie explains that, consistent with Peter’s wishes:

• He does not want life-prolonging treatment
• He does not want to be placed in intensive care
• He prefers to receive comfort-focused, palliative care at home in Grand Rapids

Honoring Peter’s Wishes: Home-Based Palliative Care

The clinician works with the hospital’s care team and local home health and hospice services to arrange home-based palliative care for Peter. In Grand Rapids, this may involve:

• Coordination with local palliative care or hospice organizations
• Home visits by nurses, social workers, and other support staff
• Symptom management focused on comfort and quality of life

Peter is discharged home with a palliative care plan that reflects his advance care directive and the choices he made with Josie and his healthcare team.

Soon after returning home, Peter dies peacefully with his wife beside him—just as he had hoped. His advance care planning:

• Reduced stress and uncertainty for Josie and their family
• Helped the Grand Rapids medical team provide care that matched his values
• Ensured that he could remain at home, in familiar surroundings, at the end of life

Advance Care Planning Resources in Grand Rapids, Michigan

If you live in Grand Rapids or the surrounding West Michigan area and want to start your own advance care plan, you can:

Talk to Your Healthcare Provider

Ask your:

• Primary care doctor or nurse practitioner
• Specialist (such as a neurologist or cardiologist)
• Social worker or care manager

at local systems such as:

• Spectrum Health
• Trinity Health Grand Rapids
• Metro Health
• Mercy Health

They can provide Michigan-specific advance directive forms and explain your options.

Connect With Local Public Health Resources

• Kent County Health Department – Offers community health information and may direct you to local aging, palliative care, and advance care planning resources.
• Grand Rapids Public Health and community clinics – Can help connect you with social workers, patient advocates, and educational materials.

Consider Michigan’s Seasons and Your Health

In West Michigan, cold winters, icy sidewalks, and respiratory infections are common concerns—especially for older adults and people with chronic conditions. An advance care plan can help you:

• Decide what kind of care you would want if you developed a serious infection, fall-related injury, or complications from chronic disease
• Clarify whether you would want hospitalization, ICU care, or only comfort-focused treatment

Key Takeaways for Grand Rapids Residents

• Start conversations early, before a crisis happens.
• Talk about what matters most in your everyday life, not just medical treatments.
• Put your wishes in writing using Michigan-appropriate advance directive forms.
• Appoint a trusted medical treatment decision maker (healthcare proxy).
• Share your plan with family and your Grand Rapids healthcare team.

Peter and Josie’s story shows how advance care planning in Grand Rapids, Michigan can help ensure that your care matches your values, supports your family, and gives you more control over how and where you are cared for—especially as health needs change over time.