Avoid the Heartache of Not Knowing Your Patient’s Wishes.

Have you ever noticed that we spend a lot of time planning for a birth, but avoid talking about end-of-life issues? Perhaps we have not come to terms with dying as a natural part of living, but when given the opportunity to talk about their wishes for end-of-life care, most people choose quality over quantity of life. When wishes AREN’T shared, it often results in end-of-life care that is aggressive, expensive and not aligned with what the patient and their loved ones want. Everyone wins when that (potentially) difficult conversation is had and the wishes are shared.

National Healthcare Decisions Day on April 16th provides the perfect opportunity to start talking about end-of-life care wishes. The aim is to educate and empower the public and providers about the importance of advance care planning and honoring those wishes. Thoughtful Life Conversations (TLC), a statewide initiative charged with radically changing the way we live and die in Arizona, has declared the month of April “Arizona Healthcare Decision Month” because we know it can take more than one day or one conversation.

The data for our state provides a snapshot of what the current experience in end-of-life care planning is and shines a light on where we can improve. A high-level review of data and surveys, complete with observations and recommendations, can be found in our recent publication, but it’s clear we will need innovative solutions and cross-sector partners to move the needle.

An interesting correlation showing conversations between Arizona physicians and their patients often happen too little and too late can be found between the End-of-Life data for Medicare FFS Beneficiaries with Parts A & B  and the physician survey done by the Arizona Medical Association and the Arizona Osteopathic Association’s End-of-Life Task Force. The End-of-Life Task Force suggests that to improve symptom management, reduce suffering and lower the utilization of acute care services, they recommend:

  1. earlier referrals to Palliative Care and Hospice
  2. interdisciplinary training on how to talk to patients who are seriously ill
  3. community education on the importance of advance care planning

Thoughtful Life Conversations offers resources for the last two recommendations via outreach and education across the state. These programs are aimed at increasing awareness about the importance of planning for end-of-life care. Education for healthcare professionals provides tools on how to initiate serious illness conversations in order to determine and honor their patients’ goal. Other workshops are geared towards community members that want to choose their preferred end-of-life care or are working with a loved one to identify their wishes.

Whether we are clinicians, caregivers or family members, we shouldn’t shy away from taking the time to have the conversation about end-of-life wishes. Avoid the heartache of not knowing. Share this blog. Be part of the movement to improve end-of-life care in Arizona and share these resources during Arizona Healthcare Decision Month.

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