by Deanna Rudy, MSW, LGSW
Hospice Grief Counselor
On April 16, we recognize National Healthcare Decisions Day (NHDD). This now-nationwide initiative began in 2008 in an effort to encourage and demystify the process of advanced care planning. So, what is advanced care planning? It is deciding what kind of medical care we want during a future health crisis or serious illness and communicating our wishes to our loved ones now in the event we are unable to do so in the future. We might be unable to communicate as a result of a serious illness, an unexpected medical emergency, or if we lose the mental ability to make informed decisions about the care we receive. One of the most important aspects of advanced care planning is talking to our loved ones about our wishes – and in detail. For example, I’ve met many people who say they don’t want to be “hooked up to tubes.” But there are more interventions involving tubes than advanced life support – what about oxygen or IV antibiotics? If we don’t communicate our wishes, our loved ones may be left to make these decisions on their own and without our input.
As a social worker with Hospice of the Panhandle, I have had many discussions with patients about their wishes as they near their anticipated end-of-life – who they want to make decisions for them, whether they want CPR, if they want interventions such as tube feedings or IV fluids, and their preferences for final arrangements. But, although it’s hard to think about, it’s not only hospice patients who benefit from thinking ahead and communicating about the medical care they want to receive if they can no longer make their preferences known. In addition to medical issues we can anticipate, there are unexpected events happening every day and suddenly putting family members or close friends in a position to make decisions for their loved ones. Advanced care planning is one way we can all prepare for these unexpected events.
Advanced care planning often includes completing advanced directives for health care such as a Medical Power of Attorney or Living Will. These documents spell out who we want to make decisions for us in the event we cannot, and what kind of medical treatment we want for ourselves during a serious illness. There are so many medical interventions available to us during a health crisis or extended illness: cardiopulmonary resuscitation (CPR), mechanical breathing (ventilation), dialysis to support failing kidneys, tube feedings if we are unable to swallow, and oxygen support, to name just a few. Do you know which of these you might want, or not want? More importantly, does your family know what you would want in the event you can’t speak up for yourself?
If you have completed advanced directives or had conversations communicating your wishes in the past it’s important to update your documents and your loved ones if your wishes change. Often, our feelings about medical interventions change over time. For example, my thoughts on receiving CPR as a healthy 20-something might be different than my thoughts about this same intervention if I am an 80-something with multiple health issues. As our minds and bodies change, it’s important to make sure that our families are aware of how our wishes have changed. If we put these wishes in writing and update our documents when needed, we are more likely to receive the care we want for ourselves in the future, and we are reducing the burden of decision-making by giving our loved ones a guide to follow and share with medical providers and other family members.
Advanced care planning is a gift that we can give to our loved ones so that they aren’t faced with making really tough decisions for us on their own. Additional information about advanced care planning and forms to complete advance directives are available at WV Center for End-of-Life Care website (www.wvendoflife.org) or by contacting Hospice of the Panhandle’s Personalized Resource Guide Program.
Additional information on National Healthcare Decisions Day can be found at theconversationproject.org.
Deanna Rudy works as a grief counselor at Hospice of the Panhandle and has worked for the organization for three years. Deanna is a licensed social worker and earned her masters degree in social work from West Virginia University.