Hospice plays key role in fostering personal choice

One of the key responsibilities of hospice is to advocate for individuals at the end of life to ensure their personal values and priorities are honored.

Hospice of the Western Reserve works closely with doctors and health care providers in the community and with the families we serve to provide education and resources. Our ultimate goal is to empower people to make well-informed decisions for themselves so they have a plan in place that reflects their personal choices and promotes the best quality of life.

Despite the tremendous medical breakthroughs fostered by clinical research and technology, too many people are still dying in a way they would not choose. Medicine can certainly extend and improve life, but mortality is a reality that is still difficult for most of us to think about and address. As a result, there is a big gap between what people say they want and what actually happens.

Consider these facts:
  90 percent of people say that talking with their loved ones about end-of-life care is important, but only 27 percent have actually done so.
  Most people want to die at home, yet two-thirds are still dying in institutions.
  Nationwide, ICU admissions in the last 30 days of life continue to rise.

Hospice can play a role in transforming this picture by encouraging personal choice. Our teams work closely with families coping with serious illness by engaging them in Advance Care Planning, which fosters shared decision-making based on the patient’s values and goals and allows their stories to be heard and validated.

Individuals are encouraged to document their choices by completing an Advanced Directive, which in Ohio includes the Health Care Power of Attorney and Living Will forms.

Hospice of the Western Reserve has created a booklet called “Courage in Conversation: A Personal Guide,” to help families begin important conversations about end-of-life care at any stage. It includes tips, helpful worksheets and all the legal forms required by the State of Ohio. The free booklet can be downloaded at www.hospicewr.org/decisions.

Helping doctors in our region’s medical community have conversations with patients about their goals-of-care as their illness progresses can play a key role in easing the transition. Health care partners value our expertise in this area.

At the annual conference hosted by our Hospice Institute last fall, Dr. Joanna Paladino, who is affiliated with the Serious Illness Care Program at Ariadne Labs and Dana-Farber Cancer Institute, shared insights and strategies with medical professionals in our community. Paladino is a member of the team working with Dr. Atul Gawande, author of the acclaimed bestseller and PBS documentary, “Being Mortal.”

It is time to transform our culture so we can have conversations about the way we want to live at the end of our lives and communicate about the kind of care we want and don’t want for ourselves. The place for this to begin is around the kitchen table, with our families, not in the intensive care unit.

William E. Finn is president and CEO at Hospice of the Western Reserve