Point of View: Not Death Panels; Life-Affirming Choices

Good sound bites do not equal good, sound decisions. As an apolitical entity, Hospice of the North Coast (HNC) is not on the “side” of any party; rather, it is on the side of terminally ill clients and their families.

The term death panel was coined to describe in frightening terms a false rumor that under a healthcare reform provision, bureaucrats would have life-or-death powers as they subjectively decided whether a person was deemed sufficiently productive to be worthy of health care. In actuality, the provision would reimburse physicians for counseling Medicare patients about living wills, advance directives and end-of-life care options.

This is a good thing! Think about it: We carry an umbrella in case of rain. We keep a flashlight on hand in case the power goes out. Yet while we conscientiously prepare for contingencies, most of us neglect to plan for life’s biggest certainty: death.

Fewer than 50% of adults have legal documents such as advance directives or living wills that delineate how far medical providers should go to keep them alive artificially. Even if they do, these documents are not always honored. This can have severe repercussions in terms of quality of life for the terminal patient, and angry arguments and financial burdens for the family. One of our board members confided to me that a primary catalyst for joining HNC was witnessing the devastating result in his own circle where denial of impending death led literally to a bitter end.

As a nonprofit hospice, our goal is to offer compassionate care that maintains a patient’s dignity and comfort while helping the family navigate the mosaic of healthcare choices. We encourage families to develop an Advanced Care Plan that includes communicating one’s wishes and designating a surrogate who can advocate and make decisions, when necessary.

People with declining chronic illnesses should speak frankly with their doctor about the comprehensive Physician Orders for Life-Sustaining Treatment (POLST) paradigm. A POLST document is a legally binding “promise” by the physician to honor the patient’s specific end-of-life medical treatment wishes, as discussed in detail between the patient and physician. Once signed by the physician, POLST travels with the patient, ensuring that a seriously ill person’s wishes regarding life-sustaining treatments are known, communicated and honored in all healthcare settings.

November is National Hospice and Palliative Care Month. I strongly encourage adults, no matter what their age or health status, to get informed and be pragmatic. Please call us at 760-431-4100 or stop by our Carlsbad office at 2525 Pio Pico Drive, Suite 301 to pick up a POLST and other forms.

It sounds counterintuitive, but hospice is not about dying; it’s about living as well and fully as you can for as long as you can. Having your wishes legally documented in advance means you will achieve what all of us want at the end of life: to make a graceful exit.

Now you know my point of view. What’s yours?

Nerice Kaufman
Nerice Kaufman, Executive Director
November 1, 2011

Share your viewpoint with Nerice at nkaufman@hospicenorthcoast.org