End-of-Life Choice, Palliative Care and Counseling

Advance Healthcare Directives Can Save Money and Family Painby Sonja


by Jean Vaneps
Duluth News Tribune
November 8, 2012

How would you like to star in your own reality show?

In applying the concept of “reality” to healthcare costs, some stark truths need to be realized by all U.S. citizens to avoid an inevitable crash. The challenge to all of us as consumers is to honestly examine our health habits and to take personal responsibility in being part of the solution to our country’s healthcare crisis.

There is one thing all of us can do, and it’s painless, proactive and will not call for any diet plan, smoking-cessation plan or payment plan. It is taking the time to complete an Advance Healthcare Directive (or just Advance Directive). The potential healthcare cost savings are staggering, but

70 percent of Americans do not have an Advance Directive, according to the Centers for Disease Control.

According to federal Medicare statistics, end-of-life care provided in 2010 accounted for more than 25 percent of total annual spending. Reasons for this include aggressive treatment that was not necessary or was not desired by the patient. Advanced medical technology has brought increases in life spans, despite chronic diseases. U.S. studies show that in areas where increased Advance Directives exist, health-care costs are reduced and patient satisfaction is high.

Before you start glazing over and saying, “It’s just another thing the doctor asks me when I go to see him,” I challenge you to fully understand the power of an Advance Directive in your life. Many people think it’s just for the old, but it’s not. It is a document completed by you on how you would like life-sustaining treatments to be provided to you when you can no longer speak for yourself. This includes young and old alike, as well as accident victims or people with chronic disease. The Advance Directive gives you control on how you want to live if sudden tragedy or chronic disease enters your life. In essence, you will be dictating your own reality, rather than allowing others make very difficult, emotion-filled decisions on your behalf.

As a nurse who has worked in health care for more than 30 years, I have experienced, both professionally and personally, the tragedy that takes place when there is conflict and turmoil between loved ones during end-of-life situations.

In a country such as ours, we may take many things for granted and may put off the inevitable: death. However, the more groundwork that is laid in communicating wishes and preferences prior to a crisis, the more that meaningful time and energy can be devoted to the crucial issue of saying goodbye to our loved ones.

The first step in developing an Advance Directive is to take the time to ask the hard questions regarding your feelings about end-of-life care. Do you really want aggressive treatment to sustain your life if there will be no quality of life?

It’s important to remember that an Advance Directive is not a death sentence. Aggressive treatment usually is included, but the sticking point is at what point are these measures withdrawn?

So who’s up for the challenge to take the first giant step in controlling your health-care dollars? Begin a dialogue with your primary-care physician to guide you to the necessary paperwork.

Though it may be a reality you don’t want to face right now, together with all Americans, this one thing, which gives you control over your own life, has the potential to make a significant dent in the preservation of future healthcare costs.