Putting the spotlight on advanced care planning
National Healthcare Decisions Day (April 16) has grown into National Healthcare Decisions Week (April 16-22) and has now expanded to the entire month of April. Whatever time period we place around it, there is no doubt (especially in the minds of the front-line hospital caregivers) that this is an important subject to each one of us.
In a study conducted by the Massachusetts Coalition for Serious Illness Care, 80 percent of respondents stated they did not want care that would reduce their quality of life below what they are willing to accept – simply to be kept alive. Conversely, 14 percent said they would want us to do whatever it takes to keep them alive.
Unfortunately, of the 85 percent of residents who believe patients and their physicians should have a conversation around end-of-life care, only 15 percent have had that conversation.
On a daily basis within our hospitals at Cape Cod Healthcare, we see the results of this lack of communication. It is truly depressing to see the frequency that our front-line physicians and nurses are left to wonder whether a patient they are caring for would really want a particular intervention if they understood its implications. It is upsetting to see how often they are brought to tears feeling they would not want an intervention done for themselves or a loved one. And how good would it be for them to know that the person they are treating is among the 14 percent who would want everything done?
It was this lack of front-line clarity that started us down the road of what has become the Quality of Life/Care Planning effort on Cape Cod. Over the time since our original summit in 2015, our Steering Committee and Task Force have made significant progress toward our goal of having over 200,000 healthcare proxy forms in our Soarian Clinicals record. Each one identifies an agent knowledgeable about what is truly important to that patient should they be unable to speak for themselves. We now have dozens of people trained to facilitate discussions in small groups wherever they may gather. The goal is for these discussions to occur in every church, synagogue, library, senior center, etc. around the Cape.
As a member of our community, I would ask that you help us in two very specific ways. The first is to exemplify the importance of this effort in your personal and family life. Have the discussion in your own family with your children as they turn 18. Before going off to college or that post-high school job, be sure your children have filled out their proxy forms identifying who they would choose to speak for them if they were unable. Be sure they also know what is important to you, and who you would choose to speak for you if you could not speak for yourself.
This is also a good time to help them understand that as they age, get married (or divorced), have their own family, they need to periodically review their proxy to account for any changes.
And most importantly, be sure to bring the completed proxy forms to the Medical Records desk at either hospital (or to your PCP office to send to Medical Records) so that at 3 a.m., when we need to know, we know where to turn.
The second way that I would ask you to help us would be to help us gain access to any groups that you are a part of. We can only use our facilitators to guide discussion by being invited into the various churches, libraries, etc., across the Cape. If there is a group that you belong to, are aware of, have influence with – please reach out to our Quality of Life e-mail or Tina Soares (information below) and help us set up that discussion. If there is a larger civic group you would like Tina or I to spend time with to help them understand the importance of promoting this across our community, please let us know that also.
To contact the Quality of Life team: