COLORADO SPRINGS — In today's Your Healthy Family, we're talking about a very important conversation that virtually no one wants to have; but it may be the most important conversation of your life.
Dr. Angela Poppe Ries, MD, MBA is the Medical Director at Pikes Peak Hospice in Colorado Springs. She says, “These conversations are difficult. No one wakes up and says, ‘let's talk about what I'm going to do at the end of my life.’ Very few people want to have that conversation.”
It’s a conversation Dr. Poppe Ries says can be full of dread and despair. “Emotions can start to escalate during conversations like this. Sometimes it's helpful to have someone from outside the situation involved, to ask questions and see what is really important to you. When families start to get emotional, that person can de-escalate things and help everyone take a deep breath and say, ‘Let's reframe what we're talking about’.”
While your wishes for your end of life care may be the last thing you want to think about, Dr. Poppe Ries says it's not so much about the end of your life, “Advanced care planning is thinking about who is important in your life, and down the road who will help you make those key decisions about your health care, about the way you live.”
Those decisions can range from one extreme to the other, and fall anywhere in between says Dr. Poppe Ries, “For some people they will say, ‘I will take any day on this planet as long as it is a day here with my family.’ We hear other people say, ‘I really want to be lucid in my own home and if I can't maintain that, then I really just want to focus on comfort and I'm not sure I want to prolong the time I have ahead of me’.”
So how do you begin such a difficult conversation with a loved one about their end of life care wishes? Where do you start? Dr. Poppe Ries says, “If you simply bring it up and say, ‘We need to talk about advance care planning,’ no one's going to have a good conversation. They may start to get nervous or think someone is sick or that you're trying to manipulate a piece of information, so I do think context is important. Some people will use a recent news event to begin the conversation like when John McCain had his brain tumor there was a lot of talk about what people would want (in that situation) and how would care be given.”
Even if the initial conversation were to not go well, it would be better than not having the conversation at all. Whether discussed or not, end of life care decisions will likely eventually have to be made with or without your input.
Dr. Poppe Ries says, “Having this conversation up front is really important. That’s not because you have to say, ‘I would never want life support,’ or, ‘I want to only focus on my comfort,’ it's just as important to know things like, ‘I would be okay living in a nursing home with a feeding tube, and I want everything done at all cost.’ If you've never expressed those wishes to your family, and you don't have that documented, your family is not going to have a true sense of what is in your heart of hearts, what you would want.”
At what point in life should people start thinking about making end of life care decisions? Dr. Poppe Ries says, “When most people get married, or have a kid and they think, ‘We really should have something set up in case something were to happen to us.’ Well that's great - but all you dealt with was what (would) happen after the accident. Right then, do the talk about the before, and what's important in that situation. If you've ever thought that you should prepare things like a last will and testament, or finances, this (end of life care decisions) needs to go right along there.”
Finally, Dr. Poppe Ries says it's important to realize finalizing end of life care decisions is a process. “It's usually not one conversation because clearly you start this conversation, you may get overwhelmed, you may go down a tangent, financial questions are going to come up. A lot of times families have to stop and take a break and regroup and come back to it.”
In a future story, Dr. Poppe Ries will talk about the legal documents that are needed to make sure your end of life care decisions is carried out and what the laws are in Colorado.
If you would like to learn more information about end of life care decisions, and how to have those conversations with a loved one- Pikes Peak Hospice can help in that process. Feel free to give them a call.
Pikes Peak Hospice is a proud sponsor of Your Healthy Family.