Transcription:
Honoring Choices: Advance Care Planning

Melanie Cole (Host): Advanced care planning is not always easy to discuss and involves thinking about future medical decisions including end of life preferences. My guest today is Sherry Meyer. She’s a social worker with Aspirus Health. Welcome to the show. Sherry, tell us what is advance care planning.

Sherry Meyer (Guest): Advanced care planning is the process for people to understand possible future health choices. It gives them the opportunity to reflect on these choices, review their values and their goals and what’s important to them, and allows them to discuss their choices with those close to them and their healthcare professionals who care for them, and make a plan for their future health care situations that may arise.

Melanie: Is this only for older people or can younger people have an advanced care planning mode to go into as well?

Sherry: Advanced care planning is for all adults--that would include those 18 and older. We strongly suggest that those folks that are 18 and older take some time to discuss their advance care planning. We would like to see all adults reviewing these documents and completing documents because no one knows their future and no one knows what may happen, where they would need to let their health care agent know what their choices and their wishes may be.

Melanie: So, then, what’s involved? How do you begin advanced care planning, and what sort of documents might you need to find? Do you need a lawyer? Tell us about advanced care planning.

Sherry: Well, what we offer here at Aspirus Medford and the Aspirus system is a process that it just takes a short period of time. Here at Medford Aspirus, we offer a monthly Honoring Choices program where we encourage our patients and our customers, our local community, to contact us, and allow us to take some time with them to complete documents. There is no need for an attorney. The documents can be completed here at our organization and we encourage people to start planning now. Again, it doesn’t take a long time, but there are a lot of questions that folks may have that we can certainly help them answer and the time to start is now.

Melanie: So, what are questions that we’re thinking about as we’re thinking about our advanced care planning and living wills and advanced directives and future choices for medical care? What kind of questions do you like your patients to ask themselves?

Sherry: Different questions like, “When would it make sense to continue certain treatments in an effort to prolong their life or seek recovery?” Who would make a good healthcare agent for them? We strongly encourage our folks that are completing an advanced directive to make sure they’re talking to the person that they would like to list on their advanced directive as their health care agent, to make sure that person is willing to follow through with what they are seeking for their healthcare goals and values. When would it make sense to stop or withhold certain treatments, and accept death when it comes? Under any circumstances, what kind of comfort care would that person want including medical, spiritual, environmental options? And, what are their personal, cultural or religious beliefs, and how do they affect that person’s decision on that advanced directive?

Melanie: So, if they’re picking somebody to be their healthcare power of attorney as it was, some people have trouble even discussing this, Sherry, and then other people say, “I don’t want to hear about it. I don’t want to talk about that now. Nothing’s going to happen.” People get in denial about these discussions. How do you pick somebody that you trust and love in your family that can help you make these decisions, should they need to be made?

Sherry: I think it starts with just having the conversation and to start talking with those around you, friends or family members that you may feel that you have trust in, and you feel that they would follow through with what your wishes would be.

Melanie: So, if you’re talking to people, you’ve made up your health care power of attorney, you’re making a written plan now, so what’s involved in that written plan? And, once you’ve done this, is this binding or can it be changed?

Sherry: The document can always be changed. It is a legal document; however, as long as that person completing the document is of sound mind and competent, that document can be--it’s a living document, so it can be changed at any time. Folks can change their health care agent they’ve chosen. Certainly, as their life changes, we encourage folks to review the document every decade, so every 10 years. If there’s a divorce, if there’s a death, if their health has significantly become worse or they’ve developed a chronic illness, certain things throughout your life would certainly change your wishes, and that document is certainly something that can be changed at any time.

Melanie: And, people say, and as you said earlier, “I don’t know what’s going to happen so how can I plan for the unexpected?” And, what do you tell them about that?

Sherry: Looking back, we try to encourage people to review has anything happened in their past that shaped their feelings about their medical treatment? Maybe they have another loved one that was hospitalized or their health significantly declined and they experienced a situation where they wouldn’t want something like that happening to them or maybe it was a positive experience. So, we encourage our patients to look at the past and anything that might have shaped their feelings about medical treatment or medical care. What was positive about it or what do they wish might have happened differently that they could certainly anticipate for their health care in the future? Also to look at here and now. Do they have significant health problems now? What kind of things bring them joy that if a health problem prevented me from doing them, would their life be meaningful or would it have little meaning at that time? Also, if they’re already ill, do they understand what the illness is that they have and the complications that could potentially occur with that illness? And to talk about their fears and their worries that they may have about their illness or their healthcare.

Melanie: People hear the words “advanced care planning” and right away they think “hospice”. They say, “Well, if I write something out like that, no one’s going to try and revive me,” but that’s two different things they’re talking about, yes?

Sherry: That’s correct.

Melanie: So, what do you want them to know about keeping those documents handy where if EMS has to arrive at their house, these documents are front and center and they know whether they’re a DNR or whatever they’ve decided with this advance care planning?

Sherry: Well, we want those persons that are completing the advanced directive to, of course, give copies to their health care agent and their healthcare professionals. And, what we do here at Aspirus Medford is, we immediately make a copy of that document and then that document is scanned right into their medical record. So, when a patient comes into our organization, we can certainly pull that up right away on our system when they register and there’s an advanced directive tab, and we can certainly have that right on hand. We want them to make sure they’re talking with the rest of their family and their close friends--not only their health care agent but others about what their wishes may be. We also want folks to look at keeping a copy of that advanced directive where it’s easily accessible and others may know where it’s kept--in a safe deposit box or a locked drawer. And, taking a copy with them if they go to the hospital so that it can be put in their medical record if it has not already been done so. Also, on our Honoring Choices advanced care planning, we do offer on that document, there’s a small card that patients can fill out when they’re completing that to keep that in their wallet or their glove compartment so that if something does happen, they have that card with them to let EMT or EMS know that they have a document in place. And, again, to review that document. It’s not a onetime event--wishes may change as circumstances change.

Melanie: So, wrap it up for us, Sherry, if you would, about the Aspirus Honoring Choices program, what you want people to know about getting involved?

Sherry: We want people that are capable adults, again, at 18 and over, that they know that they have the right to be told about their medical choices and their benefits and risks. We want them to know that whatever they decide, it’s important to talk about your health care decisions with your physician and other healthcare professionals and, of course, your family and friends and those close to you. We also want them to discuss their future medical care, and we strongly encourage that they put these wishes into writing. This would include this advanced care planning. Making an appointment with Aspirus Medford or within the Aspirus system to at least start the conversation and come in and speak with us, look over the document, maybe take it home, discuss it with family and friends, but certainly to strongly encourage them to have the conversation and complete the document as well.

Melanie: Thank you so much, Sherry, for being with us today. It’s such important information. And for more information on the Aspirus Honoring Choices program, you can contact the Aspirus customer contact center, and you can contact that at number 1-800-847-4707. That’s 1-800-847-4707. You’re listening to Aspirus Health Talk. This is Melanie Cole, and you can find out more information at www.aspirus.org. Thanks for listening.