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New research at Stanford University shows that most doctors are reluctant to talk to their patients about what matters most at end-of-life. The Standford Letter Project will help you write a simple letter to your doctor about your values and life goals. Many people have written their letters and given them to their doctors. Write your letter now! The link at the bottom of the page will take you to the letter in different languages.
My Doctor’s name _________________________________
RE: What matters most to me at the end of my life
I have been reading and thinking about end-of-life issues lately. I realize how important it is that I communicate my wishes to you and my family. I know that you are very busy.
You may find it awkward to talk to me about my end-of-life wishes or you may feel that it is too early for me to have this conversation. So I am writing this letter to clarify what matters most to me.
My name ______________________________________
What Matters Most to Me
Examples: Being at home, doing gardening, going to church, playing with my grandchildren
My important future life milestones
Examples: my 10th wedding anniversary, my grandson high school graduation, birth of my granddaughter
Here is how we prefer to handle bad news in my family
Examples: We talk openly about it, we shield the children from it, we do not like to talk about it, we do not tell the patient
Here is how we make medical decisions in our family
Examples: I make the decision myself, my entire family has to agree on major decisions about me, my daughter who is a nurse makes the decisions etc.
Here is who I want making medical decisions for me when I am not able to make my own decisions
1._______________ 2._____________ 3._______________
What I DO NOT want at the end of my life
☐ I do not want to be on a breathing machine
☐ I do not want artificial liquid feeding
☐ I do not want dialysis
☐ I do not want to spend my last days in a hospital
What I DO WANT at the end of life
☐ I want to be pain free
☐ I want to spend my the last days in the hospital
☐ I want you to help me die gently and naturally
☐ I want to die at home
☐ I want hospice care
If my pain and distress are difficult to control, please sedate me (make with sleep with sleep medicines) even if this means that I may die sooner
☐ Yes ☐ No
What to do when my family wants you to do something different than what I want for myself?
☐ I am asking you to show them this letter and guide my family to follow my wishes.
☐ I want you to override my wishes as my family knows best.
☐ Other information you want to convey
Please scan this letter into my medical records in a place where your colleagues can read this and be guided by it. I thank you doctor for listening to me now and for the future work you are about to do guided by what matters most to me.
Your grateful patient, ____________________________
View this full document, and others in different languages HERE
Today is National Healthcare Decisions Day – A day to consider your options and share your wishes regarding the type of medical treatment and end of life care you want to receive in the event that you cannot speak for yourself.
Why does this matter? Let me share my experience with you….
At age 21, I watched my father’s health deteriorate after he was diagnosed with bladder cancer. Although he was given the option to make his medical care and end of life wishes known he did not give any instructions to his family or the medical team treating him. What happened next was horrible and a memory I cannot erase from my mind.
The cancer quickly progressed to his brain which left him incapacitated – his brain had shut down. My mother and I were forced to confront the end of his life, before he even died. It has been nearly 13 years since that Summer day when my family and I sat with a nurse to decide my father’s fate. I would not wish this upon anyone. THIS is why National Healthcare Decisions Day matters!
Yes, it is true….most people do not want to think about their own demise but let’s face it – modern technology hasn’t made it possible for any of us to live forever….at least not yet! We recognize that it can be hard to get the ball rolling, which is why we have some pointers to start the conversation as well as links to the legal forms for all 50 state advance directive forms.
Today, we challenge you to start the conversation about end of life planning by using our top 10 conversation starters. Share these with your friends by visiting our Facebook page, Pinterest board, or follow the conversation #nhdd on Twitter.com.
When you die, there are many decisions to be made about your remains. Many people choose to have their bodies cremated after death; others choose an in-ground burial; still others choose to have their remains preserved in a mausoleum. Today, thanks to the great advances in medical science, more and more people are coming to realize the life-giving benefits of organ donation. By donating your organs upon your death, you give the gift of life to many others.
Last year alone, more than one million people benefited from organ and tissue transplants and each year that number grows. By donating your organs and tissue upon your death, you make the choice to provide life saving benefits to people all over the world.
Making the choice to donate your organs is an important decision, and one that you need to make sooner rather than later. Death can strike anyone at any time, and making the decision ahead of time to donate your organs guarantees that your death will bring life to needy and dying people.
Organ donation is completely cost free to the family of the donator and people of all races, nationalities, and ages are welcome organ donors. And the majority of world religions support the life-giving concept of organ donation, so there’s no need to concern yourself over difficult ethical issues.
It’s estimated that every ten minutes, a needy patient is added to the organ donation list. Sadly, thousands of the people on this list will die before receiving the organ they need. You can help decrease those numbers and increase the number of people who are able to go on living life thanks to your organ or tissue donation. Being an organ donor allows you to give the gift of life after you die, and guarantees you will be remembered for your selfless and humble act.
As you consider your life and the good you can bring to this world, make sure to look into organ donation and how you can give the gift of life after your death. Signing up to be an organ donor is easy and will give you comfort knowing that when you die, your life will continue to bring meaning to others. You can sign up to be an organ donor at most DMV’s (when updating or getting a license/identification card) or online.
Vetted prediction tools can help estimate end-of-life, but clear and empathetic discussions with dying patients and their families are more important.
by Susan Kreimer
End-of-life conversations are common in hospital medicine, and Caitlin Foxley, MD, FHM, is no stranger to their nuance. She offers patients and loved ones as much factual information as she can. And regardless of their preference—aggressive treatment, comfort care, something in between—it’s ultimately their choice, not hers. But no matter what, she will ensure the patient’s pain remains under control.
“The way I practice is to allow my patients to make the end-of-life decision that is in accordance with their wishes, and not simply push the least expensive one on them,” says Dr. Foxley, medical director of IMI Hospitalists and hospital service chief of internal medicine at Nebraska Medical Center in Omaha. However, she adds, “most people, given accurate information in a compassionate manner, would choose to die at home, and not in an ICU on a ventilator, with chemo and pressers going through a central line.”
Although hospitalists differ in their approaches to end-of-life discussions, most agree that the majority of critically ill patients want to know their prognosis. Tested end-of-life prediction tools (more…)