Advance Directives and Advance Care Planning

Advance Directives

Are We at a “Tipping” Point?

How is it that 24 years after the Patient Self-Determination Act went into effect we have not made significant progress in increasing the percentage of people who have Advance Directives?  Death has been hidden behind hospital doors for almost a century, new funeral and memorial technology has advanced, and people still seem to think that death is optional and prefer to avoid the end of life discussion.

Current research shows that only about 25% of the population has completed Advance Directives, yet 80% of the population states that they wish to die at home.  Many of us have talked till we are blue in the face, much money has been spent, and many different initiatives have been started but the number hasn’t budged.

All of this may seem discouraging but there are several different moves afoot that may open the subject up and bring it into the mainstream.  Things like:

  • Respecting Choices – an advance care planning model that has been inculcated into the fabric of the community in La Crosse, WI and has been around long enough to demonstrate significant community, personal, and financial impacts that are being noticed and shared.
  • Institutes of higher learning have started and/or increased their emphasis on end of life care and Advance Directives in their medical and nursing school curriculums planting the seed for better communications with patients in the future.
  • Accountable Care Organizations and Medical Home models are being encouraged by Health and Human Services to collect and report data on the advance care planning, that they are providing to seniors, which will eventually impact their reimbursements.
  • Ever increasing numbers of people, bothered by the lack of discussion and emphasis placed on the needs of people at the end of life, have taken the initiative to develop electronic tools on the internet to guide and help people address these issues before the need arises.
  • And, as I referred to in last month’s newsletter, Death and Dying Cafes and Dinner Parties are becoming increasingly popular in the U.S. as the underlying need to talk about death and our beliefs about it are being met through this informal yet growing medium.

Making advance care planning and Advance Directives a part of the mainstream of American life, where it is considered inappropriate not to discuss our thoughts and feelings on these issues, will go a long way towards increasing percentages in the future.  With the pace of change upon us we may just be at the beginning of that tipping point.  More people will be willing to have “the conversation” and give “the gift”.

Contributed by M Jane Markley LLC, www.mjmarkley.com

By |March 17th, 2014|Categories: Advance Directives, Death, death cafes, death dinner parties, end of life, Memorial Technology|Tags: , , , , , , |Comments Off on Advance Directives and Advance Care Planning

Death Cafes and Dinner Parties??

Death Cafes

Death Cafes and Dinner Parties

 

I know what you are thinking.  “Why would anyone participate in something like this?  I like to enjoy my dinner and this doesn’t sound like fun.”  Talking about death over dinner might not be the usual way you get people over to your house for a meal, but it couldn’t be more crucial.

Too many people are dying in a way they wouldn’t choose, and too many of their loved ones are left feeling bereaved, guilty, and uncertain.  Having “the conversation” about end of life care wishes with family, friends, and even total strangers is an important step you can take to ensure that those wishes are understood and respected.

Death Cafes and Dinner Parties

These types of activities, also known as Tea Parties, Death Cafes, etc., have taken off worldwide.    And why is that?  It is because they work.  They allow people to discuss death and related issues and be open to a variety of opinions and issues in a non-judgmental and safe environment.  A colleague of mine, Laurel Lewis, has been hosting these dinner parties for several years with growing interest and attendance such that there is usually a waiting list.  You can learn more about her and what she does at http://laurelllewis.com.

You can also see a sample of one of her dinners on You Tube at http://youtu.be/N2SOlsDTXK8  (Deepak Chopra @ a death and dying dinner party!).  This dinner is rare as it includes a well known physician but that is certainly not necessary.

The Death Cafe which started in Europe is now in the States and lets you know what is happening so check it out at http://www.deathcafe.com .   Another site provides a tutorial on how to set up such a get together.  You can check it out here at http://www.deathoverdinner.org.  An alternative approach used by Paula Schneider of Nevada is to host “Open Forums on End of Life Issues.”  Whatever terms you need to use to get people there, listening, and engaging is what is important.

Why Not Take the First Step?

These dinners and teas are meant specifically for any person who is going to die.  Does that describe you?  So, you need not wait till Thanksgiving this year to have the conversation with family and friends.  You can start now either hosting your own party or getting on line and seeing what meeting is in your area that you can attend to have the experience.

Yes, as I always remind you, it is time to have ‘the conversation’ because you never know when the crisis will occur.  Your discussions will help you feel more comfortable about documenting your wishes allowing you to give ‘the gift’ to your friends and loved ones.  Unless you are certain of your immortality, now is the time to get started!

*Contributed by M. Jane Markley Consulting, LLC

 

By |February 15th, 2014|Categories: Death, death and dying, death cafes, death dinner parties, death over dinner, end of life|Tags: , , , , , , |Comments Off on Death Cafes and Dinner Parties??