TMH Living Well: Now’s the time for advance care planning
April 25, 2014
It's easy to put off making decisions about end-of-life care. With nothing to make it urgent we can delay it for years, sometimes until it's too late. That was the thought behind National Healthcare Decisions Day in April — a movement to inspire, educate and empower people about the importance of advance care planning.
Most people don't want to think about their loved ones dying, or face the idea of dying themselves. Yet knowing wishes about medical care and personal desires is critically important in helping the transition be a peaceful one rather than stressful one.
According to the U.S. Agency for Healthcare Research and Quality, a recent study found that less than 50 percent of severely ill patients had advance directives in place. It's best to have your wishes recorded well in advance of a sickness and in place in case the unexpected happens. Plan to have conversations with your loved ones about end-of-life wishes before decisions need to be made, and then review them to make sure someone's wishes don't change in the here and now.
It's good to know that there are resources available to help you get started with advance care planning. Locally, the Northwest Colorado Visiting Nurse Association's Hospice and Palliative Care Team helps patients and their families create advanced directives and determine their wishes.
"One of the most important gifts we give our patients and families in hospice is a sense of control over what's happening. Our only agenda is to support them in whatever they need and desire. Sometimes patients desire a springboard for determining their wishes and needs — and that's where the Conversation Project comes in," said Sandy Beran, with the Northwest Colorado Visiting Nurse Association's Hospice and Palliative Care Team.
The Hospice team promotes The Conversation Project, a national project that helps people start conversations about their wishes for end-of-life care with loved ones. The project makes it easy by supplying a starter kit (http://theconversationproject.org) to anyone who is interested.
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The Conversation Starter Kit guides patients to think about what's important to them, and how they would like to live their final days. It also helps patients decide where they stand on end-of-life care — as in how much or how little medical intervention they desire. It's much more than simply filling out advanced directives; it's about having the conversations that make it possible.
Getting advanced directives and a living will in place is step one. Step two is informing your doctor to ensure your wishes will be carried out. According to AHRQ, between 65 and 76 percent of physicians were not aware that a terminally ill patient of theirs had an advance directive.
To start with advance care planning, visit The Memorial Hospital's website and download a common advance directives form available in English and Spanish at http://www.thememorialhospital.com/resources/forms. From there, peruse the Aging with Dignity Five Wishes site for a clear outline about what kind of choices you can make for end-of-life care. The Five Wishes help you outline some of the common decisions you need to make, such as who you want to make health care decisions for you, and what kind of medical treatment you want or don't want.
"When families don't have the conversation, and then say a patient can't speak, the family has to guess and then weigh each other's differing opinions. That can cause tension. It is hard to think straight when your heart is hurting and you are experiencing all the feelings of grief like anger, sadness and a loss of control. That's why having a plan in place beforehand can be so helpful," Beran said.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig — improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.