End-of-Life Choice, Palliative Care and Counseling

Posts TaggedAdvance Directive

April 16: The Day Our Country Talks About Advance Planning

Planning a vacation is fun. Planning a wedding is exciting. Planning a meeting is important. Planning for your future healthcare is critical, which is why Compassion & Choices makes such a big deal out of National Healthcare Decisions Day (NHDD).

Every April 16, a coalition of more than 100 national organizations mobilizes to talk to as many Americans as possible about getting their healthcare wishes written down and expressing those wishes to their family, loved ones and healthcare providers. That means making sure you have an advance directive, which includes a living will (describing the treatment you want) and a durable power of attorney (designating the person who will speak for you) in the event that you are sick and cannot speak for yourself. Compassion & Choices has the tools you need to get your advance planning process started. Visit our website today by clicking here. More

“Make Your Plan” Urges End-of-Life Care Advocacy Organization

by Compassion & Choices Staff
April 10, 2013

National Healthcare Decisions Day is April 16th

Portland, OR – With only one in four Americans stating their end-of-life care decisions before they are incapacitated, Compassion & Choices today asked all Americans to “Make Your Plan” for National Healthcare Decisions Day (NHDD), April 16. The importance of planning ahead was evident in the February 6 edition of The Journal of the American Medical Association, which reported that 26% of Medicare beneficiaries spent part of their last month of life in an intensive care unit — an increase from a decade ago.

The organization offers resources free of charge, including advance directive forms for every state and tools to stimulate discussion and aid decision-making. Forms can be downloaded at compassionandchoices.org or ordered by phone at 800.247.7421.

Compassion & Choices also announced the availability of exclusive content: a dementia provision for advance directives. According to a report released last month by the Alzheimer’s Association, Alzheimer’s deaths continue to rise — increasing 68 percent from 2000-2010. The new provision can be added to any advance directive or living will to advise physicians and family of the wishes of a patient with Alzheimer’s disease or other forms of dementia.

President Barbara Coombs Lee explained why the dementia provision is so important. “Most advance directives take effect only when a person is unable to make healthcare decisions and is either ‘permanently unconscious’ or ‘terminally ill,’” she said. “But what of the situation in which a person suffers from severe dementia but is neither unconscious nor dying? Without this provision in advance directives, families and doctors have no sure guide for the care of the estimated 450,000 people who will die this year with Alzheimer’s.”

Compassion & Choices has launched a social media campaign featuring bold graphics and the taglines “Ask me” and “Tell me” to prompt discussion of advance care planning, sharing the graphics from its Facebook page: facebook.com/CompassionandChoices.

Completing advance directives is the first step toward patients receiving the care they want – and only the care they want. Compassion & Choices is conducting a national campaign to stop unwanted medical treatment so that healthcare providers and institutions take all steps to honor patients’ wishes. The campaign petition can be found here: tinyurl.com/umt-petition

For more information please visit www.compassionandchoices.org

Compassion & Choices is a nonprofit organization working to improve care and expand choice at the end of life. We support, educate and advocate.

A Precious Gift for Those You Love

by Terrell B. Vanaken
Daily Republic
January 10, 2013

During the holiday season, we often think of giving in terms of tangible, often costly items.

There is, however, an extremely valuable gift that we can offer at any time of year, and which costs virtually nothing. It’s something all of us can offer to our family and loved ones. It’s the knowledge and understanding of what we would want done at the time of a health emergency, when we cannot make decisions for ourselves.

An advance directive, when properly completed, is a legal document that stipulates who should make decisions at a time when an individual no longer can. It also allows you to specify your wishes for medical treatment and just how aggressive medical personnel should be with your care.

At a minimum, an advance directive should name the primary person you trust most to make major health care decisions about your welfare. This person is called your “agent” for health care decisions. You may also name an alternate in case your first choice is unavailable for any reason.

An advance directive can be completed by any adult and is made legal by the signature of a notary public or the signatures of two qualified witnesses. Of course, as we grow older, a directive becomes more and more important, since the incidence of health care emergencies increases as we age.

Many critically ill patients and families who I have met in the hospital have never sat down and actually talked about their wishes before such a tragedy occurs. We all tend to avoid these discussions, but after a stroke, a heart attack or life-threatening event, your loved one may not be able to talk at all or understand these issues. More

Choosing Options for Life-Sustaining Care: Advance Directive Will Ensure Your Wishes Are Followed

The Chicago Tribune
January 9, 2012

Mr. J. had an implantable cardioverter defibrillator (ICD) for advanced heart failure. Having survived one episode of cardiac arrest, in which he nearly died, he was at high risk for another episode caused by a rapid, unorganized heart rhythm called ventricular fibrillation. Should this happen, the ICD would shock his heart back into normal rhythm. But at his daughter’s wedding, the ICD fired nine times. Each time, it saved his life, but the painful episodes terrified him, and he asked that the ICD be turned off.

Dr. Eva Chittenden, associate director of palliative care at Harvard-affiliated Massachusetts General Hospital, met with Mr. J. to explore his decision further. He stated that he’d already been hospitalized five times within 12 months, and he felt this took too much time away from his family.

They discussed his personal values and what action he’d want taken if his heart stopped, and the ICD was no longer there to revive him.

After long talks with Dr. Chittenden and his family, Mr. J. chose a “Do Not Attempt Resuscitation/Do Not Intubate (DNAR/DNI)” order. The decision meant he could continue seeing his cardiologist and other doctors, remain on his medications, and return to the hospital for intravenous diuretics. But he would not be revived if his heart stopped.

Doctors wish all their patients would make their preferences known in advance, like Mr. J. did. More

When Doctors Need E-mail Reminders to Talk to Patients About Death

by Lindsay Abrams
The Atlantic
January 7, 2013

You know how if someone e-mails you over and over, and doesn’t stop until you finally respond or just go ahead and do what they’ve been asking you to, it’s really annoying, but also a pretty good strategy on their part because they ended up getting what they wanted?

The same thing, it turns out, works with doctors. Only in this case what they’re being nagged about is having an important conversation with terminally ill patients that, let’s be honest, they shouldn’t have been avoiding or forgetting in the first place.

The number of patients with incurable cancer whose charts indicate whether or not they want to be resuscitated can be doubled, a new study in the Journal of Clinical Oncology found, provided doctors are sent e-mails reminding them to ask.

Per national guidelines, this conversation is supposed to occur when a patient’s prognosis is less than a year. More