Speaking About End-of-Life Care

Last week the Oregon Humanities Center in downtown Portland hosted an unusual topic for a Friday night: Death. Dr. Ira Byock, a Dartmouth professor of medicine and writer on end-of-life and palliative care issues, talked about how most Americans aren’t receiving the kind of end-of-life care they would prefer.  “In surveys,“ Byock says, “an overwhelming majority of people say they would prefer to die at home, but most people actually end up dying in hospital ICUs or nursing homes.”

Dr. Byock stressed the importance of family discussions and of discussing decisions with one’s doctor. He talked about the “death panel” controversy during the fight over Obamacare as a “political ploy,” which scared people into thinking the government would have the power to decide who would live and who would die.

The truth is that filling out a Advance Healthcare Directive lets your family and physician know what you want and don’t want in the way of comfort care and treatment at the end of your life. It also protects your loved ones from having to make what might be unbearably difficult decisions during a medical crisis.

Advance Healthcare Directives speak for you only if you are unable to speak for yourself. You appoint a healthcare agent you trust to carry out your wishes about when to provide, withhold or withdraw care; when to provide pain relief even if it will shorten your life; and how to handle organ donation and other issues.

Local author and end-of-life educator, Diane Goble, who spoke on this taboo subject last week at Sisters Library, said,  “without ‘The Conversation’ to clarify values and preferences, and filling out personal Advance Healthcare Directives, conflict can tear a family apart at a time when they need to come together and be there for their loved one.”

At the bedside of a seriously ill parent is not the time to be arguing about what the person might have wanted. Without guidance from the dying parent, one adult sibling may say mom would have wanted “everything” done, while another says mom would never want to live with a feeding tube or ventilator.

Studies show that families who discuss end-of-life choices beforehand are able to mange the stress and grief process in healthier ways. With everybody on the same page, family can spend time comforting each other and the dying patient, not arguing about healthcare decisions.

Image“The best gift you can give your children,” Goble says, “is knowledge of your end-of-life wishes.” Tell your loved ones what you want—then put it in writing. Talk with your doctor. You do not need a lawyer. You’ll find all the forms you need at http://www.compassionandchoices.org. For more information, contact Diane Goble at dianegoble@mac.com

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