Back in April, it was former First Lady Barbara Bush. Just the past few days, Arizona Senator John McCain. Comfort care, discontinue medical treatment, and other similar phrases have been thrown around. Unfortunately these phrases have been equated to giving up. This couldn’t be farther from the truth. These memorable political figures had end of life discussions with their providers and family members, and when the time came, publicized their end of life choices. They died surrounded by loved ones. They had a say in how and where they died, in the type of treatment they would or would not like to receive, because they engaged in the conversation. Making their preferences public has sparked conversation around end of life care.
It’s a Personal Choice
Each person has the right to choose how and where they would like to die. Many times, this does not happen. A poll by California Health Care Foundation found that if diagnosed with a serious illness, nearly 8 in 10 Californians would want to have an end of life care conversation with their provider. In reality, fewer than 1 in 10 report having these conversations.
Advance Care Planning is a lifelong process, and should start with a conversation, whether that be around a dinner table, or with a health care provider. It’s important that these wishes be documented, whether that be with a Goals of Care note, an Advance Directive, a POLST form for those with a serious illness, and expected to die within the next year, or any other advance care planning document. Documentation helps guide providers and family members, as they know what conversations you’ve had, what you value, and treatments you may or may not want to receive.
It’s Not Uncommon to Change Goals of Care
As someone ages, or as a disease progresses, it’s not uncommon to change goals of care and treatments. Goals may change, as one may have attended that important family event, one of the goals they discussed with their provider. Curative treatment recommendations may change as a result of the disease progression, or a new disease may arise. As a result, one may choose treatment that focuses on comfort care. It’s a personal choice.
Comfort Care Is a Form of Treatment
Palliative care, or comfort care, may be seen by some as giving up, when in fact, it’s the opposite. The patient still receives treatment, just not curative treatment. According to CAPC, palliative care focuses on providing relief from symptoms and stress of the serious illness. The goal is to improve the quality of life for the patient and the family. Palliative care can be provided in conjunction with curative treatment, and palliative care is not just for those at end of life.
Communication is, and continues to be key. Whether one chooses aggressive, curative treatment until their last day or comfort care only, each person should get to decide how and where they would like to die. Having influential political figures publicize their decisions continues to drive discussion around the importance of advance care planning.