In my last blog post, I shared with you how important it is to have a conversation with family and friends about end-of-life care, and how helpful I, as a doctor, find the information to guide me in the care and counsel I provide to my patients when they have recorded their wishes in the form of “advance directives.”
This Saturday, April 16th, is National Healthcare Decisions Day (NHDD), so it seemed an appropriate time to raise the topic again. National Healthcare Decisions Day was created to build awareness and to educate everyone, even people who are young and healthy, to think about and document their healthcare treatment choices before a crisis occurs.
I know this conversation can be difficult and uncomfortable. I know many people don’t like or don’t want to think about the end of their life – it’s emotional and it’s personal. That’s exactly why it’s so important to let your loved ones know what choices and decisions you would want them to make for you in case you are unable to make those choices for yourself.
It’s important to know, too, that people just like you are talking about this with their family members. A Pew Research Center study of 1,500 Americans found that 69% of those who are married say they have had a conversation with their husband or wife about their spouse’s wishes for end-of-life medical care. Among those with living parents, 57% say they have spoken with their mother – and 48% with their father – about the parent’s requests for end-of-life treatment.
If you don’t quite know how to get started, here are a few good resources:
- Engage with Grace has created simple, clear tools to guide you and your loved ones through this conversation so that all aspects of your wishes can be revealed.
- The NHDD website is resource-rich in providing education and information about advance directives and how to approach the planning and recording of your preferences for your care.
- The American Bar Association has compiled a helpful guide that defines what a healthcare proxy is and how to legally designate someone to represent you and your end-of-life wishes.
- Caring Connections offers free, state-specific advance directives for all 50 states and DC that meet the legal requirements for each state.
As I mentioned before, I encourage my patients to talk with me about the care they want, and I encourage you to do the same with your doctor. The U.S. Agency for Healthcare Research and Quality, in an article titled, “Advance Care Planning: Preferences for Care at the End of Life,” found the following:
- Only 12% of patients with an advance directive had received input from their physician in its development.
- Between 65% and 76% of physicians whose patients had an advance directive were not aware that it existed.
I am unfortunately not surprised by these numbers. As passionately as I feel about this issue, I know it can be difficult to know if a patient or family is ready for this conversation. Because I try to make it a part of “usual care,” my patients aren’t surprised when I ask. I want my patients to know that I am ready to have this conversation, and hope they view me as a valuable resource and guide for them as they define their wishes. I encourage you to take these steps, too – part of good care is planning ahead!