Giving the Gift of an Advanced Medical Directive
Riverside Health System joins organizations across the country on National Healthcare Decisions Day, April 16, 2014, encouraging individuals of all ages to have conversations about their medical wishes.
Newport News, VA – There's no doubt about it…thinking about death, especially your own, is no easy task. Talking about it with people you love, whether you're 30 years old or 80 years old, is even harder. Add to this asking someone to make decisions on your behalf if you become so ill you can't do it on your own, and it's easy to see why a majority of Americans do not have Advance Medical Directives or Medical Powers of Attorney in place.
But it doesn't have to be that difficult, experts say, especially when people start thinking about these conversations as a gift – gifts you can give on April 16 during the 7th Annual National Healthcare Decisions Day or anytime during the year.
"It's hard to think about these things," said Dr. Laura Cunnington, Riverside Health System's Medical Director for Palliative Care and Hospice Services. "The flip side is that it is so much harder if you haven't thought about it and someone has to figure out what they should do for you. You give them a gift by taking that burden away."
Healthcare organizations are required to provide information about healthcare decision-making rights and to ask all patients if they have an Advance Directive. Making future healthcare decisions includes much more than deciding what care they would or would not want. Instead, the National Hospice and Palliative Care Organization recommends that we think about how we want to live. "That's what this is really about," says Cunnington. "When the end of life is near, our experience of living – being with our family, being free of pain and suffering – are the things that become important to most people."
"Only 25 percent of adults are estimated to have Advance Medical Directives completed and in place," said Carol Wilson, Riverside's Director of Palliative Care Services and Advance Care Planning. More so, only half of the adults who have an advanced illness have done the planning. "In general, young people think about it less," Wilson said. "We all like to think we're immortal and this planning requires us to think about what makes life worth living, if we would want to be kept alive at the end of a terminal illness or in the event of a brain injury, and under what conditions we would want treatment stopped."
Even Cunnington used to be part of that statistic. "When my husband and I were in our 30s, he was in a terrible motorcycle accident and he was unconscious for three days," she said. "He's fine now. But at that time we hadn't had the conversation. You think you know someone so well because they are your spouse, but when it comes to life and death decisions it's far better to have had that conversation."
"Advance Medical Directives not only should be done by everyone, but should also be updated and revisited as you age," Cunnington said. "What your Advanced Care Directive says in your 30s could be different if you are in your 60s and have a diagnosis of a serious illness." Cunnington said.
The reasons many people have not started this type of planning, Cunnington said, is "No time." "Not important." "Didn't want to talk about something so depressing." Cunnington gets that. "I'm a palliative medicine physician and I have these discussions all day, every day," she said. "When I have these discussions with my own parents, though, it's not easy."
So Cunnington talks about Advance Medical Directives as a gift. "Once you get to the hospital, there may be a multitude of reasons why you can't make your own decisions," Cunnington said. "Having a loved one in the hospital can be very distressing for families. It's already stressful enough to be in the hospital, but then to be asked to make decisions like this can be very hard. Having your wishes already in place at this difficult time is a gift to them, as they make difficult decisions about your care.
For more information about advance care planning, visit http://www.riversideonline.com/patients_guests/advance-directives.cfm
Published: April 9, 2014