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Discussing the direction of life in later years

April 13, 2013
Submitted by Wendy Chirieleison, community health educator for HealthLink Littauer , The Leader Herald

What are your long-term care goals and wishes? What are your preferences on the best living environment for you, pain management, having control over decisions regarding your health care, your end of life wishes? Does your family and loved ones know how you feel? It is important to think about what you would like your long term care to look like and make sure that your family members are aware so they can ensure your goals are met and your wishes are honored.

How do you begin?

April 16 is National Health Care Decisions Day, a time when you are encouraged to discuss this important information with family and loved ones. That would be an ideal day to visit TheConversationProject.org where you can gather ideas about what and how to discuss this information with your family.

What the research shows

Surveys done by The Conversation Project suggest that only 44 percent of people say that they have communicated their end of life wishes to their families and loved ones. Many times, what people say they want to happen and what actually happens is very different. The Center for Disease Control reports that 70 percent of people say they prefer to remain at home during their final days. However, 70 percent of people wind up in a hospital, nursing home, or other long-term care facility. The California Health Care Foundation found that 82 percent of people think it is important to put their long term care wishes in writing, but only 23 percent of people actually do it. You should be the expert on your wishes, because you know better than anyone else what you would want for your long term care.

Difficult conversations

Deciding how you want to live can seem like a difficult task. Here are some important things to consider that can help guide you to developing a road map to your long-term care conversation. Read each statement below and rate them on a scale from 1-5, 1 being the least important and 5 being the most important.

Rating Scale:1-5:

I want my doctors to do what they think is best.

I am worried that I won't get enough care.

I am worried that my care might be too aggressive.

I want to live as long as possible, no matter what.

Quality of life is more important to me than quantity.

I wouldn't mind going to a nursing facility if necessary.

I want to live independently no matter what.

I want my loved ones to do what they think is best for me, even if it goes against my wishes.

Who should you talk to?

Who do you want to speak on your behalf regarding health related issues? Choose someone that you can trust to speak for you. Think about when would be a good time to have this conversation, and where you would be most comfortable. Be sure that you have your road map for this conversation. You could start the conversation by asking for help with something, or by saying that you would like help in thinking about the future.

What else?

Patricia Bombard, vice president and medical director of Geriatrics for Excellus Health Plan, suggests families need compassion, support and education when helping seniors make plans for their lives. Goals and decisions should be focused on the individual's desires first and foremost, and be based on reliable information.

Keeping that in mind, it is very important to think about what medical interventions you would want or would not want such as resuscitation, a feeding tube, or a breathing machine, and then determining if these services are available to you at facilities you may wish to reside in, such as assisted living facilities.

You could also consider using legal and medical documents to put your wishes on paper. There are a few different forms that are important. First is Advanced Care Planning, which is a document that will summarize everything you have been reading about in this article. An Advance Directive, or a Living Will, is a document that states your wishes for health care in the event that you are unable to communicate them. Finally, a Health Care Proxy is a document that identifies the person you chose to make medical decisions on your behalf in the event that you are unable to do so.

For more information, ideas and links to important documents, visit theconversationproject.org and compassionandsupport.org. You can also attend a free program entitled "Advance Care Planning" on April 24 from noon to 1 p.m. in Littauer's Auditorium presented by the Rev. Bonnie Orth, Pastoral Care coordinator. For more information, call HealthLink Littauer at 736-1120.

 
 

 

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