Tag Archives: amd

Louie B Free Show with Jeff Zucker and Dr. Brian Yeaman

“We’re really giving a user friendly experience at MyDirectives for people to answer questions that mean something to them to get better care in the future if you’re ever in a crisis.” – Jeff Zucker, CEO and co-founder of MyDirectives  on the Louie B Free Show

New York Times on Care at the End of Life

Over the weekend, we were encouraged to open our copy of Sunday’s New York Times to read this in an editorial, “Care at the End of Life,” about end-of-life decisions and planning:

Three years ago, at the height of the debate over health care reform, there was an uproar over a voluntary provision that encouraged doctors to discuss with Medicare patients the kinds of treatments they would want as they neared the end of life. That thoughtful provision was left out of the final bill after right-wing commentators and Republican politicians denounced it falsely as a step toward euthanasia and “death panels.”

Fortunately, advance planning for end-of-life decisions has been going on for years and is continuing to spread despite the demagogy on the issue in 2009. There is good evidence that, done properly, it can greatly increase the likelihood that patients will get the care they really want. And, as a secondary benefit, their choices may help reduce the cost of health care as well.

… No matter what the death-panel fearmongers say, end-of-life conversations and medical orders detailing what care to provide increase the confidence of patients that they will get the care they really want. In some cases, that could well mean the request to be spared costly tests, procedures and heroic measures that provide no real medical benefit.

But while we’re happy to see the New York Times tackling advance care planning, we think advance planning isn’t just for the end of life. It’s also for medical crises – for the 20-year-old on her way back to college after a break who is in a car accident or for the 35-year-old who collapses suddenly while out jogging.

Healthcare emergencies can arise at any time in your life, and some, while not life threatening, may prevent you from expressing your wishes. Less than a third of Americans currently have an advance directive. As a result, millions of Americans arrive at these most vulnerable moments of their lives unable to face them in the manner of their choosing.

Have you completed your advance medical directive? If not, what’s keeping you from laying out your plan? Share your thoughts with us in the comment section below, on Facebook or on Twitter.

No More Clipboards.

We’ll admit it – we’ve been watching a lot of television lately. But can you really blame us? Television shows can be a useful tool to start a conversation.

Take the most recent episode of Grey’s Anatomy as an example. In the premiere, as we discussed in a post last week, we saw how the docs dealt with carrying out their friend and colleague’s advance medical directive and living will.  But in the second episode, the writers took us back in time to when he created it.

Take a look:

Notice the clipboard?  We did.

The decisions Mark Sloan makes are too important to wait until the last minute – too important for a clipboard. Sloan might be a fictional character, but his story is sadly far from fiction.

All too often patients or their families are handed a clipboard and asked questions they’ve never talked about. Let alone thought about.

We’ve all put the conversation off at some point. It’s something we don’t want to think about, but we need to.

Avoid the clipboard. Start the conversation with your family now. Here are some tips on how to start the conversation.  And after you do, let us know how it went. Did you learn something you’d like to pass on to others? Share your story on Facebook or Twitter.

Crossposted from MyDirectives.com

How to Live.

From the TV shows we’ve been watching to Monday’s New York Times op-ed by Bill Keller, it’s clear that something is going on. Something big. Something powerful. 10,000 baby boomers A DAY are turning 65. We’ve gone from the
“sandwich generation” term to the new phrase: the “club sandwich” because we’re taking care of kids, siblings, parents, aunts/uncles, and some grandparents. So, perhaps it’s time to have a conversation about how we want to live. Shift the focus. Empower ourselves to be a part of our future – whatever that may be.

In Monday’s op-ed, Keller writes eloquently about the end of his father-in-law’s life before exploring the differences between a health care system that allowed his father-in-law peace at the end of his life and our own in the United States:

When they told my father-in-law the hospital had done all it could, that was not, in the strictest sense, true. There was nothing the doctors could do about the large, inoperable tumor colonizing his insides. But they could have maintained his failing kidneys by putting him on dialysis. They could have continued pumping insulin to control his diabetes. He wore a pacemaker that kept his heart beating regardless of what else was happening to him, so with aggressive treatment theycould— and many hospitals would — have sustained a kind of life for a while.

But the hospital that treated him offers a protocol called the Liverpool Care Pathway for the Dying Patient, which was conceived in the 90s at a Liverpool cancer facility as a more humane alternative to the frantic end-of-life assault of desperate measures. “The Hippocratic oath just drives clinicians toward constantly treating the patient, right until the moment they die,” said Sir Thomas Hughes-Hallett, who was until recently the chief executive of the center where the protocol was designed. English doctors, he said, tell a joke about this imperative: “Why in Ireland do they put screws in coffins? To keep the doctors out.”

Keller asked an end-of-life specialist in the United States about the chances of something like his father-in-law’s experience happening here. The specialist said: “Zero.”

Keller explores why that might be, delving into the political controversy that arose a couple years ago over the so-called “death panels.” Here’s what we think though: dying in the U.S. doesn’t have to be that different from the Liverpool process.

We too can know the peace that Keller’s father-in-law did when he told his daughter: “I have fought death for so long. It is such a relief to give up.”

While we may not have a special protocol like the Liverpool Care Pathway for the Dying Patient, we do have advance medical directives, which not only allow you to make your own healthcare decisions in case you’re in a situation where you can’t speak for yourself, but also prepare you for the end of life. Directives are a document too many of us avoid. And the conversation about them with our family and friends is something some prefer to not do, but planning ahead and starting the conversation now is too important to not do.

Need help starting the conversation? Check out our conversation starters.

Have you had the conversation? Share what you learned and provide tips for others still trying to have the conversation.

Crossposted from MyDirectives.com