Have You Had the Conversation?

Have you had the conversation with your loved ones yet?  It’s the conversation that often happens too late, or not at all.  The conversation for which it’s never the right time.  The one that seems too difficult, or too painful, or too awkward.

It’s the conversation about how you want to live and how you want to die.  Have you had and documented the conversation about your wishes for care and treatment when you are nearing the end of your life or when you can no longer communicate them yourself?

Healthcare providers that start the conversation with their patients will tell you that far from being too difficult, it’s often a relief for both their patients and families.  The patient is relieved that they can have a serious and frank discussion about their wishes.  Caregivers may be relieved that a third party is facilitating what can be an emotional conversation.

Saturday, April 16th was National Healthcare Decisions Day which ” exists to inspire, educate and empower the public and providers about the importance of advance care planning.”  Healthcare providers, elder law attorneys and social workers across Indiana will tell you starting the conversation is one of the most important things they can do given the tremendous outcomes they see.

• There was the man estranged from his family who asked a neighbor to be his healthcare representative.  Within a few weeks, that neighbor unexpectedly had to make critical decisions for the man. Because they’d had and documented the conversation, the neighbor was able to communicate the man’s wishes about his care and treatment.
• There is the former nursing home administrator that took on a new job as an Advance Care Planning Coordinator because she saw how many of her patients lacked any form of documentation about their wishes, and she knew what a big difference she could make.
• There is the palliative care specialist that knows the importance of asking questions and deeply listening to the patient, meeting patients and families where ever they are, and guiding them to mutual understanding of a patient’s condition, treatment options and wishes.
• There is the elder law attorney that finds entire families are prompted to have and document the conversation about their wishes when older adults plan their estates.  Adult children realize it’s not just about their aging parents; they too need to have the conversation about their own wishes before the unexpected arises.
• And there’s the physician who reports that having and documenting the conversation results not only in patients and families feeling OK about where things are heading and what the patient wants, but also better coordinated health care overall and enhanced utilization of limited health care resources.

There’s still a lot of work to be done because not enough people are having and documenting the conversation. There are helpful resources to get you and your family started, including the PBS Frontline documentary Being Mortal, the Indiana State Department of Health Advance Directives Resources Center,  the Indiana POST Program and the Indiana Hospice and Palliative Care Organization.