En español | Don't know where to start when it comes to talking with loved ones about end-of-life wishes? Discussing such matters can be difficult, but not impossible, says geriatrician James Mittelberger, director and chief medical officer for the Optum Center for Palliative and Supportive Care.
A good time to start is National Healthcare Decisions Day, on April 16, which encourages conversations about advance planning for health care. Decisions include naming someone to speak for you when you cannot speak for yourself and identifying the kinds of medical treatments you would or would not want at the end of your life.
These discussions are important — so much so that Medicare now reimburses physicians for having advance care planning conversations with patients.
"Unless you talk about it and document your wishes, most people's families and their [health care] providers don't know what you want in different circumstances," Mittelberger says. "This creates a lot of stress for your loved ones if they don't know what you want if something serious happens and you can't express your wishes. It's important to talk and then document."
According to a national survey by the Conversation Project, a public engagement campaign to promote end-of-life discussions, more than 90 percent of people think it's important to talk about loved ones' wishes for end-of-life care, as well as their own wishes, but fewer than 30 percent have actually done it.
Here are some simple steps to begin the conversation:
- Start with your loved ones. Honest communication can help families avoid the stress of guessing what a family member would have wanted. You may find that you and your loved ones may see some things differently. Be open with each other and focus on really understanding the views of those you love.
- Think about what is most important to you. Whom would you prefer to make decisions on your behalf with your physicians if you could not? How sure are you of your choices? Discuss these topics with your loved ones to reach a shared understanding of your desires.
- Make it official. Once you've had the conversation, put your decisions in writing. An advance directive establishes a legal decision-maker who can speak for you if you are not able. It can also state your medical wishes to guide treatment decisions in that situation.
- "Most people feel good after having the conversation," Mittelberger says. "They're difficult to start, but meaningful, important and rewarding."
- For more information and resources to help you makes these decisions, go to optumcare.com.
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