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Planning for End-of-Life Care: Better Now than Later

Rita Dichele - February 01, 2016 12:21 PM

As caregivers we deal with the uncertainty of when and how our loved ones are going to die. We take the responsibility of making tough health care decisions not only to honor our loved one’s wishes, but to comply with treatment plans from a medical network of clinicians who might be strangers to us.

Unfortunately, we live in a society where the idea of death and dying is often forgotten. We tend to be pulled in the direction of taking the steps necessary to “cure” sickness at any cost. It is almost amazing that as we approach our end of life, any discussion on the topic of death is avoided.

Therefore, it is not surprising that during the formation of Obama Care or the Affordable Health Care Act, Americans believed that the discussion of end of life care was premature death or being placed on “death panels”.  It became apparent that this was a topic that made Americans squirm, believing their lives were in jeopardy as they aged. In fact, as Americans became more frightened it was dropped from the original Affordable Health Care Act.

Why does end of life care cause panic?  Simply put, end of life care is taking the appropriate steps to plan how we want our lives to end, given the amount of control we have over it.  For instance, if you were in an automobile accident what type of medical care would you want?  Do you want heroic measures?  Do heroic measures involve the first responders' need to save lives or are they medical measures that could improve persons’ quality of life?  Have your loved ones told you ahead of time what medical measures to be taken if indeed they were hurt in an automobile accident? 

Furthermore, what if your loved one was 90 or older and did not want to be resuscitated (DNR) because they knew it could affect their quality of living. Has this been told to you?  Has it been written down? Does a terminally ill cancer patient want to die at home? In addition, decisions have to sometimes be made quickly. For instance, do your loved ones want a feeding tube, incubation, or resuscitation?  

These are medical terms that can be difficult to understand, especially during a crisis.  It can add to the existing layers of stress making it all overwhelming to handle! That is why it is wise to discuss these terms beforehand especially when we are caring for loved ones. If there is an end of life care plan in place, our loved one’s wishes will be honored. 

When there isn’t any care plan, caregivers will often want health care providers to use any sort of medical assistance to prolong life. For instance, it is not uncommon to have caregivers demand clinical staff in nursing facilities to save their loved ones from death.  As you can imagine, medical assistance of this nature can lead to heroic measures, prolonging life that may affect quality of living causing loved ones to suffer unnecessarily and most importantly not what they want.

Please keep in mind that end of life care is NOT mercy killing or a form of euthanasia nor is it physician assisted death. End of life care does not mean a person’s premature death. Your loved ones die a natural death.

There are many ways to communicate end of life care. This is the first of a series of blogs that will help caregivers understand in greater detail how to meet the needs of their loved ones as they approach death.

Rita Dichele holds three Master degrees in Counseling Psychology, Health Care Administration, and Human Services.  Ms. Dichele is certified in death & dying and bereavement from the Association for Death Education and Counseling (ADEC).  She is on faculty with A.T. Still University and instructs classes in grief work and long-term care.

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