End of life care: A difficult but loving decision

April 16, 2013

Full disclosure: We’re all going to die.

When the time comes, 80 to 90 percent of us say we would prefer to do it at home, pain-free, with family and friends gathered around. This means that most have devoted at least some thought to an exit strategy. Yet, a 2010 study by the National Hospice and Palliative Care Organization found that fewer than a third of Americans have taken steps to make their end-of-life care wishes official, providing written or verbal directives to family and health care workers.

“This is something that every adult should have in place, much in the same way we purchase car insurance — not because we’re hoping to have an accident, but, should that occur, everything’s set up,” said Jeff Lujan, a licensed clinical social worker with Evercare Hospice in Colorado Springs. “A life-changing health crisis can happen any time to anyone.”

Death isn’t an easy topic to broach, especially with a loved one, but palliative and health care workers such as Lujan are hoping Tuesday — National Healthcare Decisions Day — will provide the push needed for families to start the conversation.

“Unfortunately, when we don’t talk about it, there comes a time when we’re forced to face the issue, and that can lead to a lot of guilt,” said Miranda Shaw, caregiver program coordinator at the CU Aging Center, who initiated the conversation with her parents when she was 27 and they were in their 50s. “If you talk to them about it when they’re healthy, you’re going to get better answers.”

Shaw will participate in a panel discussion, “Who Decides for You? Community Discourse on End of Life and Advance Directives,” at 4 p.m. Tuesday at the Colorado Springs Fine Arts Center. The free public forum, hosted by Gentiva Hospice and the Fine Arts Center, brings together experts from the health, medical and law fields to answer questions and discuss end of life care and options.

More than 2.4 million people die in the U.S. each year, according to the U.S. Census Bureau. While about 10 percent die suddenly, in an accident or from a heart attack or stroke, most require medical care for the final weeks, months or years of their lives.

Advance directives aren’t only for the elderly or infirm. Playing the odds when it comes to life and death could mean deferring the tough decisions to family and loved ones at a time when they’re least prepared to handle it, Lujan said.

“It could be a car accident, or you’re hiking and slip and fall and you can’t speak for yourself,” he said. “Without those advance directives in place, even though you’re the healthiest person, that unexpected event could put you right in the middle of that situation where those decisions are going to be made in your behalf.”

The first step in considering end-of-life options is to determine your own priorities when it comes to heath care, Lujan said. “Ask yourself what’s worth pursuing treatment for and what isn’t,” said Lujan, who’s seen families and doctors struggle to decide care and treatment in the absence of such directives.

“Do you want CPR? Do you want additional medical interventions or comfort care only? Those are all very personal, individualized decisions.

“That’s a terrible burden we can lift for our loved ones and doctors.”

Though emotional, the process of creating an advance directive doesn’t have to be technical or legally complex, Lujan said. “Often I find that someone has thought about this, but hasn’t taken steps. Or, they think this is a living will and ‘I’m going to have to hire a lawyer for $250 an hour,’ when actually it’s quite simple,” he said.

Contact Stephanie Earls: 636-0364

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