Have the conversation about end of life care


Advance care planning is making decisions about the care you would want to receive if you become unable to speak for yourself. These are
your decisions to make, regardless of what you choose for your care, and the decisions are based on your personal values, preferences, and discussions with your loved ones. If you are in an accident or have an illness that leaves you unable to talk about your wishes, who will speak for you? You can tell your family, friends and healthcare providers what your wishes and personal beliefs are about continuing or withdrawing medical treatments at the end of life. Advance care planning includes:

  • Getting information on the types of life-sustaining treatments that are available.
  • Deciding what types of treatment you would or would not want should you be diagnosed with a life-limiting illness.
  • Sharing your personal values with your loved ones.
  • Completing advance directives to put into writing what types of treatment you would or would not want should you be unable to speak for yourself.
  • Since January 1, 2016, Advance Care Planning is paid under the Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment Systems.

Examples of advance directives include:

  • A living will, which is a written statement of healthcare wishes to be carried out if you are unable to communicate (for example decisions related to life support, disabling pacemakers or defibrillators, nutrition, dialysis).
  • A healthcare proxy sometimes called a “healthcare surrogate” or “healthcare power of attorney,” which allows you to name a family member or trusted friend to speak on your behalf and make decisions when or if you are unable.

Advance care planning means:

  • Understanding possible future health choices
  •  Thinking about these choices and reflecting on what is important to you
  •  Talking about your decisions with loved ones and your healthcare providers
  •  Putting your decisions in writing

3 Questions Can Start ‘The Conversation’

We’re more likely to talk to our kids about safe sex and drugs than to talk to our parents about end-of-life care . We tell ourselves it’s too soon. Until one day we realize it’s too late.

Nearly half of Americans say they would rely on family or friends to carry out their wishes about end-of-life care, but most have never expressed those wishes. Some would want everything that medical technology has to offer. Others would opt for a gentle, pain-free death if their quality of life were seriously diminished.

There’s no right or wrong. Every person has the right to make that decision.

Experts say that the best way to get others to discuss end-of-life care is to do so yourself. He/she suggests that you begin the decision-making process by asking yourself these “what if” questions:

What if You had a Terminal Condition?

What if you had a terminal condition and there was no reasonable probability of recovery? What kind of treatments or life-saving measures would you consent to or refuse?

What If You Couldn’t Make Your Own Decisions?

What if you weren’t able to make these decisions for yourself? Who would you want to make them for you?

Who Would Make Medical Decisions For You?

What if that loved one needed to make those decisions? Does he or she know what you want?

When You Should Have ‘The Conversation’

We suggest using milestone events—wedding, anniversary, birthday, retirement, graduation, downsizing move, family holiday—to hold “what if” conversations. Keep it light but heartfelt. You may be surprised: letting your loved ones know your wishes could start a frank conversation among the generations about terminal illness, funerals, religious beliefs and other end-of-life concerns.

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