End of Life Planning

There is a profound need to address planning for end of life. It's a hard conversation and one that is often put off or avoided. For many families, not addressing end-of-life decisions, until a crisis, creates unnecessary stress and compromised decision making. Recent research published in the British Medical Journal concludes that a "coordinated, systematic model of patient centered advance care planning that assists in identifying and respecting patient’s wishes about end of life care, improves care from the perspective of the patient and the family, and diminishes the likelihood of stress,anxiety, and depression in surviving relatives."

Starting January 1, 2011 there is a new federal policy, outlined in a Medicare regulation, that the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment. Under the new rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves. The goal is for doctors, patients and their families to have these conversations as part of their normal health care routine, instead of when a situation forces the conversation.

Engage With Grace (http://www.engagewithgrace.org) is an organization whose mission is to help start end-of-life conversations. Their One Slide Project was designed with that goal. The slide has just five questions on it about end of life experience for yourself and for your loved ones. You can download it here. http://engagewithgrace.org/Download.aspx

According to statistics quoted by Engage with Grace, 73% of Americans say they would prefer to die at home, yet 20-50% die in hospitals. They also point out that some people are kept on life sustaining treatments way beyond the point they would have wanted. This comes at a high cost to those individuals, their families and the healthcare system.