National Health Care Decision Day

In the hospital conference room, four adult sons and daughters of Mr B. were seated in front of me. They were arguing, debating, and trying to decide what their father would want to do in this situation. The tension was palpable. Mr. B. had suffered a stroke with brain damage such that he couldn’t speak for himself. Now his family was gathered to give the medical team guidance on what his wishes would be. Mr. B. loved life, but he could no longer live without long term medical support. New medical technology provides families with many confusing and stressful choices. Would he want a feeding tube? Would he want life support machines? The brothers and sisters debated and disagreed. The one thing they all agreed on was that Mr. B. would not want to see them fighting.
I was there with the palliative care team to help care for this family during this difficult time. Our palliative care team provides physical, emotional, and spiritual support and guidance to patients and families stressed with serious illness. The team consists of physicians, nurses, a social worker and a chaplain to provide holistic family care and support. Each team member was needed as the family struggled for days with difficult decisions, guilt, and sadness.
Dealing with a serious medical illness in the family is very stressful. This stress can be compounded when a family argues over choices for medical care. It didn’t have to be this difficult for Mr.B.’s family. April 16, 2010 is National Health Care Decision day. This is a time when all adults are encouraged to discuss their health care preferences with their loved ones and document these preferences in an approved advance directive.

Advance directives come in two main forms:
1. A "healthcare power of attorney” documents the person you have selected to be your voice for your healthcare decisions if you cannot speak for yourself.
2. A "living will" documents what medical treatments you would or would not want at the end of life.
These forms can be obtained from your physician’s office or downloaded from sites like these:
CaringInfo.org
AgingWithDignity.org

A study published April 1, 2010 in the New England Journal of Medicine showed that many of us will need decisions made regarding treatment options at some point in our lives. Those that documented their wishes within advance directives were more likely to receive the care they preferred.
The documents are important in themselves, but it is also very important to discuss your wishes and have a conversation with your loved ones. When would you want to be allowed to die naturally? When would you want medical procedures to sustain life?

Five years after Terri Schiavo, 70 to 80% of Americans still have not completed advance directives. Her family’s public fight regarding her care should encourage us all to discuss and document our wishes to prevent family strife.

Take the time today to speak with your loved ones and document your wishes in an advance directive. It is a wonderful way to care for your loved ones and take the burden of these difficult decisions off their shoulders. Do not wait. Terri Schiavo was 26 when she developed her health problems. April 16, 2010 is a good day to give your family a gift. Have these discussions and complete an advance directive.


John Morris MD is a Palliative Medicine physician with Four Seasons providing consultation service daily at local hospitals. He is the Medical Director of Palliative Care for Four Seasons, which provides Circle of Life award winning palliative care services in hospitals, nursing homes, assisted living facilities and homes throughout Henderson, Buncombe and Transylvania counties.

 
For more information about Four Seasons and our services please visit our website at:  fourseasonscfl.org