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Published on April 15, 2016

Time to talk about your healthcare wishessenior-couple-with-advisor

Did you know that National Healthcare Decisions Day is today, April 16, with observance all week long? Time to break out the barbecue this weekend.


This is a day to invite the family over and talk about some of the most important issues in life: What your medical care might look like if you had a traumatic accident, a chronic condition or were approaching the end of life.

Talking with your family members or friends would be an ideal way to celebrate, said Cape Cod Healthcare Chief Medical Officer Donald A. Guadagnoli, MD.

“Speaking with their families is probably the way I would hope people would spend it,” he said. “A lot of families don’t have any idea of what their loved ones’ wishes are.”

National Healthcare Decisions Day was started by a coalition of groups to educate patients and providers about the importance of advance care planning. It’s an opportunity to talk about a healthcare proxy (which names an agent to make your medical decisions if you are incapacitated) and other documents communicating your wishes about medical procedures, such as resuscitation.

“National Healthcare Decisions Day exists to remind all of us, regardless of our current health or age, that we need make our goals values – known to someone,” said Tina Soares, BSN, RN of the Visiting Nurse Association of Cape Cod.

She encourages people to talk about their experiences and what’s important to them.

“We know these conversations can be confusing and difficult, but it’s better now than to do it in an acute crisis situation. It’s really a gift for the people that care about you”

The theme for this year’s Healthcare Decisions Day is, “It Always Seems Too Early, Until It’s Too Late,” according to the website.

Cape Cod doctors, nurses and emergency personnel see that all too often, Dr. Guadagnoli said.

“When you see the families who haven’t discussed this, it really causes a significant increase in the stress at what’s already a stressful time. At least they can have some comfort in knowing this is what (the patient) would have wanted.”

He and others recommend anyone 18 or over have a healthcare agent and anyone with a chronic condition have a document on file with their doctor and family outlining advanced care wishes. One solution is a standardized, statewide healthcare proxy form available online.

Recommended advance care planning resources and forms are available on Honoring Choices Massachusetts website and tools for starting the conversation are available through The Conversation Project website. All planning documents can be updated as health and wishes change.

This is particularly important in a place like the Cape, where 27.8 percent of the population is over 65, Dr. Guadagnoli said. In fact, the community conversation has already started.

The Quality of Life Management Community Task Force, which formed in December by Cape Cod Healthcare and several key community members, is led by Soares. The goal is to know and honor and individuals’ choices by significantly increasing the number of Cape Codders with informed advance care plans. The first step is selecting a well-prepared healthcare agent, said Soares.

“Choose a person you trust to make healthcare decisions for you based on your choices, values and beliefs, in the event that you cannot make or communicate decisions yourself,” she said.

“What we know through evidenced-based research is that advance care planning is more than just a document,” she added. “It’s a process of planning and conversation to get it right. My father would say off the cuff, ‘I never want to be put on a machine,’ but what did that mean?,” Soares asked.

When someone says, “I don’t want to be a burden to my family,” it’s an opportunity to start the conversation about what their wishes may be, she said.

The task force, which has been meeting monthly, hopes to offer community training sessions and broader resources by the fall. Next year, Soares believes there will be some local action around National Healthcare Decisions Day.

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