Advanced Care Planning: Discussing Death and Avoiding Stress
You’re sitting at your kitchen table for dinner when you receive a late-night phone call. Although you promised your partner that you wouldn’t use the phone at the table, you decide to pick it up. Moments later you find yourself en route to the hospice facility where your grandmother has suddenly slipped into an unresponsive state. While it was anticipated that you might have to act as a surrogate decision maker, it feels incredibly abrupt and stressful to be charged with making healthcare decisions on her behalf. While this scenario might seem dramatic, it is exceptionally common. Every year 15 million elderly Americans find themselves unable to make, or communicate, their healthcare decisions. This number is expected to nearly double over the next 40 years. When an individual loses their ability to communicate, family members will find themselves suddenly making complex and emotional decisions regarding the wellbeing of their loved ones. While most Americans have preferences on where and how they die, only one third of adults have directives in place for their end of life care, according to the Centers for Disease Control (CDC). Of the few adults who have prepared a plan, many do not discuss their preferences with loved ones or healthcare providers in advance. Approximately 65–76% of physicians whose patients had an advanced care directive were not aware of the documents existence, according to data from the CDC. This reality can cause incredible distress for the family when the moment for decision making arrives, but also add strain on the physician, and healthcare system as well. Properly setting up an advanced care plan can help you and your family prepare to make some of the most difficult decisions of your lives with confidence, but it is only useful when discussed openly with relevant parties. It is no secret that discussing death makes many people uncomfortable, but talking about healthcare options in advance is the only way to ensure a smooth transition of care to surrogate decision makers. While you can’t prevent death, you can prevent unnecessary stress and heartbreak for loved ones and healthcare providers alike by developing and communicating your preferred advanced care plan.
If you are interested in learning more about current work in advanced care planning, starting a discussion about death with a loved one, or creating your own advanced care plan, please see the links to a few helpful resources below:
https://www.cdc.gov/aging/pdf/advanced-care-planning-critical-issue-brief.pdf
https://helixcentre.com/project-advance-care-plans
https://www.mariecurie.org.uk/help/support/terminal-illness/planning-ahead/advance-care-planning#
Sidney Krandall, Industrial Designer & Adapt Design Co-Founder
