Are you an advocate? Do you help someone voice their needs and concerns? Do you provide needed information, or help make sense of information given to someone? Have you ever answered the question, “What would I want if I were in the other person’s shoes?” If so, chances are good that you have been an advocate. It’s both easier and harder than it sounds. If you are with your mom in the hospital, she might not want to pursue aggressive treatment for her latest exacerbation of her congestive heart failure (which now includes pneumonia), even though you believe she should. Can you effectively advocate for her in this case? You can, but it might be challenging. An advocate must adopt the views and preferences of the one advocated for, and make sure those views and preferences are heeded.
Choices in Senior Care Blog
A Palliative Care Provider recently presented to our Care Management Team. We learned some fascinating statistics and information about end of life care in the United States. He explained that Palliative Care is not strictly related to “hospice”, which targets individuals with terminal conditions within the last six months of life. Palliative Care is a philosophy of care, focused on symptom and pain management as well as patient autonomy, directed by the individual’s goals for their care. It can be described as the transition between aggressive medical treatment and hospice care.
There is a new way of thinking that is actually an old way of thinking. This new thought process is called “Slow Medicine” by some, there’s also a “Right Care Movement”, and likely other titles as well, but the idea is about asking different (better?) questions. Today, the goal in medicine is often to extend life as long as possible. This new way of thinking asks “We can; but should we?” Considering end of life issues and scenarios is an important matter, with many angles and options. Let’s say you have just received a diagnosis of lymphoma and there is a large mass present in your chest. If you are 85 and active, you are going to ask slightly different questions than if you are 85 and already very ill. If you are in your 30’s, still raising young children, you are going to be asking different questions altogether, the details matter. Just as the details shape the situation, so too do the questions that we ask. The hard thing is, there are no perfectly right answers for this, there are only the answers for you. This is why asking the right questions is so crucial. Ask questions like, “What do you want at the end of life; what do you specifically not want”? An example of where these questions are relevant is in regards to pain symptoms and management. Someone might want pain completely managed even if that means they may die sooner. Someone else may prefer to be totally alert and present, even if they are in great pain. Some may prefer to let things unfold without intervention; others may want everything possible done or at least attempted. There are no “right for everyone” answers, so it is important for us all to be considering and discussing these questions. To do this, we need to be having conversations with our loved ones and families about some uncomfortable topics, such as the end of life (Of course, this means facing the inevitability of our own finiteness and ending which could be a whole other blog post!). Our culture seems to be treating death as a distant possibility rather than an inevitability. The reality is we will all face death. We will do so prepared or surprised, and as we approach we may lose our ability to express what we want. There is no better authority to decide how you should be treated at the end of life than you. #starttheconversationnow