November is a special time of year, a time for reflection about the things we value most and for which we are most thankful. Routinely we hear stories of gratitude for good health, warm shelter and enough food for one’s family. November is a time we also hear appreciation expressed for our veterans, for our country and for the choices we have during our elections.
A lesser-known celebration during November is Hospice and Palliative Care Month. After 40 years in this country, hospice is a form of health care familiar to many. Palliative care, however, is not. According to the Centers for Medicare and Medicaid (CMS), palliative care is “patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.” Hospice is a specialized form of palliative care, delivered when a person has a terminal illness and whose life expectancy is six months or less.
Why do we celebrate hospice and palliative care? For starters, both forms of care look at the patient as a person, not just at his/her clinical diagnosis. This approach is fundamentally different from other forms of medical care that focus exclusively on cures or fixes to problems. Next, both types of care are focused on quality of life – eliminating pain and suffering caused by a disease – while addressing the spiritual, emotional and family needs as they relate to the patient’s illness. Lastly, it is to draw attention to the choices individuals have in their health care, especially for individuals living with chronic or life-limiting illness. Health care choice is a central theme for hospice and palliative care services.
Your health care choices are what we would like to celebrate this year. Recently CMS announced that it would reimburse physicians, nurse practitioners, physician assistants, and clinical nurse specialists for talking with their patients about making health care choices for the future. Known as Advance Care Planning, patients and their families can now talk with their health care providers about the kind of care they would like should they be unable to communicate their choices in the future. Being explicit about your health care choices is the first step to getting the care you desire. Make it a point to talk to your health care team at your next appointment.
The next step in the planning process is capturing your decisions in legal documents called Advance Directives. These documents – also known as a living will and a health care power of attorney – provide you and your family insight into your preferences for your future care. In addition, they let your medical caregivers know who can make decisions for you if you are unable to do so yourself. No matter what choices you make about your future care, you must be intentional about stating them and make others aware that you have made them. Your choices need to be reflected in your Advance Directives. This is a crucial step to take in helping your choices be honored.
In North Carolina, there are free Advance Directive forms available from the NC Secretary of State’s office. These forms require that your signature be notarized and witnessed by two individuals. Be sure to give signed copies of them to your loved ones and your medical team – sharing your preferences with those who might be called upon to make decisions for you. To access the official NC Advance Directive forms, visit this link.
There are many excellent resources that can help you and your family talk about your future health care. To access these resources, visit this link. Your health, treatment options, and how they impact your desired quality of life are very personal matters. And somewhere down the road, they will matter a great deal to you and to your family.
During this time of year when we celebrate and give thanks for many things, be proactive and give your family the very important gift of explicitly stating your health care choices. It is a gift that honors you and the values you hold dear; and one that removes the guesswork for your family about what you would want. It is a gift they will be most thankful for.