Prepare Site

From USA Today:

"Projects get people talking about end-of-life care"

Talking about serious illness and death is hard. That's why so few people do it. But it's important. That's why there's a growing movement to get more of these conversations going among families and friends — and to help more people get control over the kind of medical care they want at the end of their lives. The latest effort, launched Friday, is a website called Prepare (www.prepareforyourcare.org). It's designed by academic researchers, but is written at a fifth-grade level and features large type, voice-overs and how-to-videos with closed captioning — the better to reach a wide audience and help simplify what can seem like a daunting process, says project leader Rebecca Sudore, a geriatrician at the San Francisco Veterans Affairs Medical Center and associate professor at the University of California-San Francisco. Several foundations provided funding for the project.

The Prepare site breaks it down into five steps:

• Choose a medical decision-maker. Many people will quickly name a spouse, child or best friend. But 10% to 15% have no one they feel comfortable naming, Sudore says. The site suggests such folks give the matter some thought — and reassures them that they are not alone in this problem.

 

• Decide what matters most in life. Is living as long as possible the most important thing? Is comfort more important? Would you want to live if you couldn't talk to people? Videos show how people might discuss these issues.

• Flexibility for your decision-maker? Do you want them to always do exactly what you said — or would you want them to have flexibility in some situations?

• Tell others about your wishes. The list may include a decision-maker, doctors, family members and friends.

• Ask doctors the right questions. When medical choices arise, ask about risks, benefits and other options. Some people also want to ask how sick they are or how long they have to live.

Many people who have these conversations will end up filling out advance care directives, formal statements that name medical decision-makers and future preferences. People who already are very sick may, in many states, sign a form called Physician Orders for Life-Sustaining Treatment, which says whether they ever want cardiopulmonary resuscitation, feeding tubes or other interventions.

Such forms "can be helpful," Sudore says. "But life is messy. A form will not help you figure out what's important to you or how to communicate effectively with your doctors or loved ones."

Susan Tolle, director of the Center for Ethics in Health Care at Oregon Health & Science University, agrees: "Advance care planning is not an event, it's a process." While paperwork helps, she says, conversations are more important. Research shows that decision-makers who have had these conversations feel less distress about their decisions, whatever they are, she says.

^ It's good to think about these kinds of things even though most people do not/will not. Things can happen at a moment's notice and by then it could be too late. ^

http://www.usatoday.com/story/news/nation/2013/01/04/prepare-health-care-conversations/1807963/