End-of-Life Choice, Palliative Care and Counseling

Posts TaggedAdvance Directive

Advance Healthcare Directives Can Save Money and Family Pain

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. More

A Revolving Door to Avoid

by Judith Graham
The New York Times
October 25, 2012

Two weeks ago, Dr. Arif Nazir got a call from a colleague about a 79-year-old woman at an Indianapolis hospital. The cardiologist on the phone explained there was nothing more that could be done for this patient, who had advanced heart failure, chronic lung disease and diabetes.

After a brief conversation, Dr. Nazir agreed to admit her to a nursing home and try to keep her out of the hospital, respecting her recently signed “do not resuscitate” order, or D.N.R.

It was a promise that was broken within several hours, much to Dr. Nazir’s dismay. The reasons highlight troublesome problems with long-term care that frequently frustrate caregivers and that are receiving fresh attention from medical providers and Medicare. More

Three Generations Gather for End-of-Life Conversation

by Maggy Patrick
ABC News
October 9, 2012

Norb Ranz and his daughter Maureen Jennings have always talked about everything — except one thing. So the two decided to gather three generations at Jennings’ childhood home on his 85th birthday to talk about what Ranz may want at the end of his days.

“My dad is 85 today… he’s still very, very active,” she said. “He’s a great storyteller and a wonderful friend.

The family talked about everything from what the service would be like to what they would do if Ranz’ health declined.

“Now we’re just asking that you share some of your thoughts about what you would like at the end of your life, so that we can honor your wishes,” Jennings said.

“How strongly do you feel about staying in your house? If you have the resources to stay here … is that something that’s really important to you?” she asked him.

“I would miss it, but anybody would,” Ranz responded. “If the time comes and I can’t take care of it, or know enough people who will help me take care of it … but it’s still kind of fun to be here.”

Jennings and her sister Molly Calhoun used their mother — who passed away earlier this year — as a touchstone to talk about how important knowing their father’s wishes were to them. More

Teens Want Voice in End-of-Life Decisions

By Serena Gordon
U.S. News & World Report
October 9, 2012

Teens and young adults who are seriously ill should have a chance to be involved in end-of-life decisions, and a new planning guide — developed especially for this age group — can help, researchers say.

“It’s OK to raise these issues and open up communication,” said Lori Wiener, director of the pediatric psychosocial support and research program at the U.S. National Cancer Institute and lead author of a study that helped develop the new guide.

“Adolescents and young adults often stay silent and secret because they don’t want to share their fears — because they don’t want to upset their parents. And parents don’t bring up end-of-life issues for the same reasons,” she explained. More

End-of-Life Options Worthy of Attention

By Joe Timmerman
The Badger Herald
September 25, 2012

Death is a very difficult topic to discuss. It’s not a subject that most people enjoy pondering. It is especially difficult to discuss with someone whose death may be imminent. Like many issues, it might be easier to just avoid the topic altogether. However, as is often the case, pretending the issue doesn’t exist won’t make it go away, and can often make the end result more difficult to deal with. Thus, the news the Madison medical community will start providing end-of-life planning as a standard patient service is welcome, indeed.

End-of-life planning involves sitting down and coming up with an “advanced directive.” An advanced directive is essentially a set of written instructions regarding a patient’s preferred medical care that are carried out in the event the patient is no longer able to make those decisions. For example, a patient might specify that, if they should enter into a vegetative state, they should be taken off the ventilator and allowed to die.

Preparations for death, such as end-of-life planning, are becoming increasingly accepted in the medical community. According to guidelines published by the American Society of Clinical Oncology, all terminally ill patients should sit down and discuss their end-of-life wishes with their family and health care team.

Advanced directives are beneficial for a variety of reasons. To begin with, people should have their health care administered according to their own preferences. If someone wishes to be kept alive on a ventilator, then he or she should be able to. If someone wishes instead not to be put on a ventilator, then they shouldn’t have to be put on one against their will. Just because someone can’t communicate his or her preference doesn’t mean it shouldn’t be honored. Either way, this is utility enhancing for the patient. More