Eight Things You Need to Know About "the Conversation"

Article Date: Apr 16, 2014

Dr. Heather MorganThe patient suffered from mild dementia and both he and his daughter worried about his care when his condition worsened.

Heather Morgan, M.D., asked him what was important to him. "I want to be able to enjoy Husker football and I want to enjoy ice cream," he told her. He wrote down his wishes for his end-of-life care. "He helped his daughter and he helped me know how to proceed when his condition worsened," the Alegent Creighton Clinic palliative and geriatric care physician said. "He went peacefully."

Maybe you don't know how to start talking about it. Perhaps it's too awkward a subject to bring up. Or you just don't expect to be in a life-threatening situation.

"Events could come up at any time," Dr. Morgan said. "You could be in a car accident. A slip or fall could be fatal." She said now is the time to write down your wishes in an Advance Directive. "I have the conversation with all my patients,"she said. "It's hard to acknowledge our mortality. Even if it just starts the thinking process, it's a head bop."

More than 90 percent of people surveyed last year said it's imporant to talk about end-of-life care. But only 30 percent had discussed it with their family. "At least do it for your kids," Dr. Morgan said. "They won't have to make tough decisions because they'll already know your wishes."

April 16th is National Healthcare Decisions Day and at Alegent Creighton Health, our doctors and other caregivers will be talking about Advance Directives with patients. Here are eight things you need to know:

  1. If there's a time you can't make your own healthcare decisions because of illness, Advance Directives become helpful tools for those who have to make decisions for you. They're called Advance Directives because you fill them out in advance of a time when you can't make your own decisions.
  2. Think about what you want. What matters to you at the end of your life? Do you want long-term ventilator support? How long do you want to receive medical care? How important to you is living independently? How involved do you want your loved ones to be?
  3. Typical information to include is (1) your healthcare and treatment preferences, (2) who you want to make decisions when you can't, (3) who can make decisions about your mental healthcare and treatment specifically and (4) what life-sustaining treatment you prefer. This is if you have a terminal condition or are in a persistent vegetative state or a state of permanent unconsciousness.
  4. Talk with your physician and those close to you about your wishes.
  5. Once you've completed the documents, be sure to give copies to those who need to know: your doctor, any healthcare facility in which you receive care and the person you designate to make decisions when you are no longer able to do so.
  6. You don't have to complete Advance Directives documents to get medical care. If you don't name a decision-maker, your providers will look to the following in this order: your spouse, your adult children collectively, your parents, your siblings and your next closest relative.
  7. An Advance Directive doesn't go into effect until your doctor determines you are unable to make your own decisions.
  8. It's your responsibility to give a copy of your Advance Directive to your doctors and decision-makers. You should review the papers periodically to be sure your preferences haven't changed.

It's not easy to think about – or talk about – the end of your life. But this tough conversation is one of the most important conversations you're likely to have.
Learn more about Advance Directives here.

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Related Links
Advanced Directives

Heather Morgan, M.D.

National Healthcare Decisions Day