How do you want to spend the last days of your life? This question may not be the ideal subject for cocktail party conversation, but end-of-life care is a topic worth discussing with your loved ones and your doctor. Starting Jan. 1, 2016, Medicare beneficiaries are encouraged to have this conversation during a dedicated office visit through a new covered benefit called advance care planning.
Thinking about your mortality and end-of-life medical care is difficult; talking about it is even harder. In fact, older adults are more likely to have discussed what do with family belongings after their passing than end-of-life medical decisions, according to the Pew Research Center.
Planning for the kind of health care you want and who you want making decisions can offer peace of mind to you and your family during a stressful, emotional time. Starting this conversation in a dedicated office visit allows your doctor to learn and support your wishes when responding to medical situations.
What is end-of-life care?
End-of-life care is the care you receive in the days or even years before you die. This care can be because of sudden events or terminal illness. Many Medicare services can be used to provide curative or palliative care at the end of life. That’s why it’s important to think through what kind of care and services you would want implemented and why.
What is advance care planning (ACP)?
Advance care planning encompasses discussing your end-of-life health care options, your personal preferences, and how you would like to communicate this information to your friends and family.
How to start the conversation with your doctor:
- Ask questions. Use this time to talk candidly with your doctor about decisions, procedures or services that support care and treatment. Share any fears or concerns you may have about these and why. Discuss how you handle uncertain or unexpected news. And discuss what matters most to you in how you spend your time.
- Don’t wait. The benefit of starting the conversation early means your concerns and choices are heard in advance of an unforeseen medical crisis or condition. More than one out of four older Americans have questions about their medical treatment near end of life but are not capable of making the decision, according to the National Institute on Aging.
- Gather information. Making informed decisions requires gathering information – from others and yourself. These are extremely personal decisions. Taking the time to find out about your values, wishes and beliefs will help.
- Write down your thoughts. Some people find it easier to write out their responses to these questions. You can bring this document to your visit to help get started. Try using a template (see resources below) to prompt important topics to bring along with you for your discussion.
- Continue the conversation. Your preferences aren’t final and can be readjusted. Revisiting your decisions and preferences is normal as your health and circumstances change. That’s also the benefit of having a primary care provider who knows you and any changes in your health.
This conversation will provide a road map for your health care options to ensure you receive the amount of care you want, not more or less.
The advance care planning (ACP) benefit starts Jan. 1, 2016 and can be part of your Annual Wellness Visit (also a Medicare-covered benefit) or discussed during another problem-focused visit. Advance care planning conversations are encouraged but completely voluntary and not required. Schedule an appointment today with your Polyclinic doctor.
- The Stanford Letter Project - The Stanford Letter Project provides a letter template to help make starting this conversation easier.
- The Conversation Project
- “Take Advantage of Medicare Preventive Services – They’re Free”
- Medicare Annual Wellness Visit