By Dr. Richard Ries and Dr. (Lt. Col.) Matthew Studer, Tripler Army Medical CenterApril 9, 2013
HONOLULU -- If a loved one were in a serious accident or suddenly diagnosed with a life-threatening condition, do you know what their wishes are regarding end-of-life care? Does your family know your wishes?
Unfortunately, candid discussions about the complexities of end-of-life care for many patients are often either delayed or worse yet, never take place.
National Healthcare Decisions Day, recognized April 16 annually, aims to provide a venue for patients, families and healthcare providers to initiate a dialogue about medical choices in the context of the individual's values. Tripler Army Medical Center will join other healthcare facilities around the country to promote the sixth annual recognition.
Representatives from Tripler's Ethics Committee will be available be available at the hospital entrances, April 16, 8-11 a.m., to share information and address questions patients and providers have about end-of-life care and healthcare planning.
An additional discussion about advance healthcare decisions will be held later that day at noon in the 10th floor conference room.
Advance healthcare planning, formally known as an advance directive, is written documentation of these choices and preferences. It affords us the opportunity to consider and appoint a loved one to speak on our behalf in the event we are no longer able to communicate those wishes ourselves.
Advance directives became legally binding agreements in 1990 when congress enacted the Patient Self-Determination Act. Since that time, more and more patients have elected to make their wishes known before serious medical problems arise, but Tripler would like to see more of its patients move forward with such planning, and involve a healthcare provider they trust.
According to a U.S. Agency for Healthcare Research and Quality broad study, fewer than 50 percent of terminally ill patients had advance directives in their medical records, and only 12 percent of patients with an advance directive had received input from their physician in its development. Additionally, between 65-76 percent of physicians whose patients had an existing advance directive were not aware their patients had one.
Tripler's Ethics Committee wants to encourage better communication between healthcare providers and patients, and more awareness of advance healthcare planning options among its patients.
Studies published in the Journal of the American Medical Association have shown that having an open dialogue and subsequent healthcare planning improve patient quality of life and end-of-life care. It also supports surviving family members by minimizing stress, anxiety and depression.
National Healthcare Decisions Day is a call to all of us as a community to take a peek beyond our typical view toward mortality. It challenges healthcare providers, patients and families to encourage one another to lift their heads from the proverbial sand and openly discuss the healthcare wishes of an individual before illness potentially takes that ability away.
Talking about death isn't always easy, but it is an important opportunity to consider what things are important to us, and share those beliefs with those around us to ensure that those caring for us have our guidance.
Further information on National Healthcare Decisions Day and how to comfortably navigate the process of creating an advance directive is available at your primary care provider's office, through Tripler's social work department, or online at www.NHDD.org.
(Editor's Note: Dr. Richard Ries is a resiliency subject matter expert with the Pacific Regional Medical Command's Care Provider Support Program and member of Tripler Army Medical Center's Ethics Committee. Dr. (Lt. Col.) Matthew Studer is the chief of Pediatric Cardiology and chair of the Ethics Committee at Tripler.)