End-of-Life Choice, Palliative Care and Counseling

Posts TaggedMassachusetts

Personal Decisions Matter at End Of Life

The Republican
Wednesday, April 27, 2011

When family members take on the responsibility of caring for a loved one nearing the end of life or are called upon to make health-care decisions on behalf of their loved one because he or she is unable to speak, suddenly the enormity of this responsibility looms large.

What would my loved one want? Do we continue with yet another medical treatment?

Do we withhold high-tech life support? Do we want intensive medical interventions that may prolong suffering?

How far do we go? How do we assure quality of life as the end nears?

Of primary concern is the question, “How do we honor those we love, respecting the dignity of their values and preferences for life care?”

As an individual, your decisions matter. This is especially true when it comes time to examine how you plan and prepare your health-care and quality-of-life decisions as they communicate your wishes for end-of-life treatment.

Did you know that nearly 70 percent of Americans say they would rather die at home, surrounded by family members? Yet in Massachusetts this expectation is reversed; 70 percent die in nursing homes or in hospitals, often spending their last days hooked up to high-tech life support machines. Fewer than 25 percent die at home.

Recently, family members caring for their dying mother at home related how grateful they were because their mother had made her wishes known and clearly communicated what she desired and wanted.

“She made it easy for us because all we have to do is follow what she wanted,” they said.

This reality does not remove the gamut of emotions that accompany them as they tend to their mother. But it does remove the struggle of having to decide on their own without the assurance their decision would in fact really be what their mother wanted.

They do not have to worry about the guilt, remorse or uncertainty that comes when loving guidance is not clearly communicated.

Do yourself and your loved ones a favor. Be willing to enter into conversations about what health-care choices you would desire if you were unable to speak for yourself. Convey your wishes through an advance directive. Advance directives enable others to know in advance what your choices are.

A “health-care proxy” documents the person you select to be your voice when you cannot speak for yourself.

A “living will” documents what kind of medical treatments you would or would not want at the end of life.

Quaboag Valley Hospice is available to offer assistance by providing literature and tools to assist with thoughtful reflection on health care choices. They are also available for group presentations and additional information as needed. They may be reached at (413) 283-9715.

Most importantly, remember and affirm that your decision matters. Take the time to reflect on what you desire for your health care and what quality of life means for you. Then offer your gift of love by adequately communicating your choices so your wishes and life may be fully honored.

The Rev. Domenic K. Ciannella, an Episcopal priest, is hospice chaplain with Quaboag Valley Hospice of Wing Memorial Hospital in Palmer. He is also certified as a grief recovery specialist and is well versed in crisis intervention and pastoral care.

Compassion & Choices praises intent of Massachusetts Death with Dignity Bill

Compassion & Choices, the nation’s oldest and largest nonprofit working to expand end-of-life care and choice, today applauded the intent of a Massachusetts measure to legalize physician aid in dying, but expressed doubts that the Legislature will vote to support patients’ rights to make their own end-of-life decisions. “Too many Americans suffer needlessly and endure unrelenting pain,” said Barbara Coombs Lee, president of Compassion & Choices. “This measure contains good, proven public policy that is now the law in Oregon, Washington and Montana. It’s unfortunate that so many politicians fail to serve the people who want and need this choice.” Not all citizens have the opportunity to vote directly on Death with Dignity proposals, like those in Washington State, which passed it by a large margin.

Oregon’s 11-year experience teaches that end-of-life choice has benefited not only the patients who used the law, but all Oregonians facing the end of life. All dying patients in the state benefited from improved care from physicians and health care providers, increased use of medical morphine, increased referrals to hospice, the lowest rates of in-hospital deaths and the greatest opportunity to die at home among loved ones in the nation.

National surveys over twenty years have shown a large majority of Americans support making physician aid in dying a legal choice. “Americans want choices in all aspects of their lives. The right to choose how we die echoes the right to choose how we live,” said Coombs Lee. “Because such an overwhelming majority holds this view, one day everyone will know the comfort of choice and control. It is time for federal and state governments to honor the will of the people and legalize aid in dying.”