Discussing and Planning for End-of-Life

endoflifeBy: Nahda Harati: Meritage ACO Patient Care Coordinator

“In this world, nothing can be said to be certain except death and taxes” -Benjamin Franklin

While this may be true, Meritage Medical Network is dedicated to allowing individuals the ability to take some control over the former. With our “Because I Care Campaign,” MMN has been seeking to normalize and emphasize the importance of discussing end-of-life care, and creating a plan to ensure patient wishes are followed via official documentation.

There are two unique legal documents to do this that are available to persons of all ages and backgrounds. The first is an Advanced Health Care Directive (AHCD) and the second, a Physician Order for Life Sustaining Treatment (POLST). Both documents are voluntary, require an appointed decisionmaker, and explicitly relay an individual’s end of life wishes. Many types of AHCDs exist but each allow patients the ability to designate a Power of Attorney for Health Care and/or function as an instructional manuscript indicating patients’ healthcare wishes. Unlike the POLST, an AHCD allows an individual to free write their wishes, making it more personalized. A POLST is a document created for individuals in a more critical condition. It is a notably bright pink, double-sided document, with check boxes to dictate whether or not one would like CPR, specific medical interventions, or extraordinary measures like a feeding tube.

With an increasing number of individuals suffering from chronic illnesses, POLSTs and AHCDs are becoming especially important. To put it simply, death has become more complicated. Not only do these end-of-life documents allow for individuals to make their wishes known, they also allow for specialized care, simplifying a usually very complicated process. By having a conversation with a healthcare professional about end-of-life planning, misconceptions of medicine and lifesaving procedures can be eliminated. This can uncover insights into what an individual truly wants from their healthcare team.

For example, CPR is a very well-known lifesaving procedure, yet few know the risks associated with such a maneuver. In elderly individuals, the procedure ends with broken ribs and possibly a breathing tube shortly after. By having the end-of-life conversation, an individual can discover this information before a life threatening event and make an educated decision on their POLST or AHCD as to what measures they would like taken if such a situation were to arise. A sad truth is that many individuals and families struggle when a loved one reaches the end of their life. Making decisions at that point can be difficult and near impossible when no one can agree. Having the end-of-life conversation can improve understanding and communication between family members and prevent unnecessary pain and suffering. By ending the conversation with an AHCD and/or POLST, the individual can rest assured that he/she will receive the care they want, when they want it.

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