Difficult discussion on death important

How we want to die – and don’t want to die – is one of the most important conversations that America is not having. According to a survey published by Excellus Blue Cross Blue Shield in 2008, 80 percent of upstate residents think it is very important to have a living will that directs their end-of-life care, but only 27 percent have one.

April 16 is National Healthcare Decisions Day. The goal of this nation-wide initiative is to ensure that all adults in America have both the information and the opportunity to communicate and document their healthcare wishes.

Research suggests that half of us won’t be able to make our own healthcare decisions at the end of life because the vast majority of us will die from chronic disease, not a sudden event. Doctors and family members won’t know our preferences if we do not put them in writing and share them.

Making healthcare decisions is often difficult in the best of circumstances; making decisions for others who cannot speak for themselves is more complicated. Each of us has the ability to guide our healthcare providers and our loved ones about what we want. “Advance directives” (living wills, healthcare proxies, etc.) give us the ability to document the types of healthcare we do and do not want, and to name an “agent” to speak for us if we cannot speak for ourselves.

With the Patient Self-Determination Act of 1990, Congress affirmed the right of every citizen to set forth his or her future healthcare wishes in writing with an advance directive. Yet various estimates suggest that a minority of Americans have done so. Because advance directives can be created without a lawyer, for free, and relatively easily, this figure is astonishingly low. In recognition of this, National Healthcare Decisions Day strives to provide much-needed information to the public, reduce the number of tragedies that occur when a person’s wishes are unknown, and improve the ability of healthcare facilities and providers to offer informed and thoughtful guidance about advance health-care planning to their patients.

New York State has made it easier for people with a life limiting illness in 2008 to get all “the care they want, but only the care they want” and document the same through the use of MOLST – Medical Orders for Life Sustaining Treatment, as well as through passage of the Family Health Care Decision Act and Palliative Care Information Act. The legislative attention given advance care planning at the state and Federal level underscores the importance of putting our individual healthcare needs and preferences first.

Family conversations are pivotal to exploring, accepting and documenting end-of-life wishes. And so Hospice Chautauqua County and the Chautauqua Cares Coalition of the Chautauqua County Health Network are teaming up to sponsor community dinners the week of National Healthcare Decisions Day. These dinners, which we are calling “Death Over Dinner,” are opportunities for community members to share a conversation with friends or family members about their wishes for end-of-life care. Those wishing to document their wishes with living wills or healthcare proxies will be able to do so at the dinners.

These two-hour “Death Over Dinner” discussions, made possible in part with funding from Univera Healthcare and the Chautauqua Region Community Foundation, will take place over catered dinners in community centers around the county and will be guided by trained facilitators. Communities where these dinners will take place are Stow, Fredonia, Jamestown, Cherry Creek, Westfield and Findley Lake. If you would like to know more about how to attend one of these events, make a reservation or host a table of friends or family, please visit www.HospiceChautCo.org. Those without internet access or questions can call 665-6602.

If you prefer to explore the options for advance care planning on your own, we suggest you visit www.compassionandsupport.org for a variety of free information including free advance directives forms and tools to assist with thoughtful reflection on healthcare choices. Finally, please share this information with your loved ones, your proxy and your physician and consider having your directives recorded in the Chautauqua Cares Health Care Proxy Registry so that area hospitals and healthcare provides can easily access it.

With healthcare, “your decisions matter.” However, others need to know your wishes to honor them. There are no wrong answers when thinking about healthcare choices and completing an advance directive. Please use April 16 to discuss, decide and document your wishes, whatever they may be.

Ron Sellers is president and chief executive officer of Hospice Chautauqua County. Ann M Abdella is the executive director of the Chautauqua County Health Network.