Avoiding Hazards at the End of Life

Avoiding Hazards at the End of Life

Editor’s note: this is the first post in a two-part series. The second post will appear in my blog on February 1st.

5 hazards many people face at the end of life (part 1) and how to avoid them (part 2).

“Plan the work, and work the plan.” That was the mantra of my boss 30 years ago as I was just beginning in my career. Another one of his favorite quips was, “Note that hazard is the core of the word haphazard. Working haphazardly without a plan is hazardous.” I can almost hear his voice as I reflect on the wisdom he imparted.

Hazard road sign

Photo courtesy: Thinkstock / Zoram Zeremski

Most Americans experience a haphazard end-of-life journey. For fear of acknowledging death, most adults enter their final days without a plan that can actually guide loved ones, decision-makers and healthcare providers if the patient is unable to make his or her own decisions.

A conspiracy of silence stifles important and oh-so-necessary family conversation. Adult children do not want to upset aging parents by asking Mom or Dad about end-of-life healthcare preferences. Mom and Dad side-step the topic to avoid rattling adult children and grandchildren.

Those who bravely venture into “the conversation” struggle to articulate medical preferences. Even Tom Brokaw—a truly skilled communicator—stumbled when trying to convey his wishes to his daughter.

A few checked boxes on a Living Will is not sufficient.

Lack of meaningful planning and thoughtful family conversation leads to chaos, confusion and conflict in a medical crisis. Any number of hazards can be experienced by the patient, loved ones and even doctors, including:

  1. Wrong care. The patient receives too little—or too much medical care.
  2. Wrong decisions made by the wrong person. The patient’s wishes are ignored because the wrong person takes charge of the medical decisions.
  3. Family pain. Loved ones argue over treatment choices for the patient—sometimes even going to battle with one another. Relationships are damaged.
  4. Huge bills. Medical expenses build up, reflecting high-cost care that the patient never wanted. Loved ones are faced with enormous hospital bills.
  5. Moral angst. Medical professionals feel compelled to deliver all possible care to avoid litigation, even when knowing additional treatment will not help the patient and might actually cause suffering.

Patients, loved ones and doctors can experience a more peaceful journey through a medical crisis with a modicum of preparation. My next post will offer 4 simple steps that can help you and those you love to avoid painful end-of-life hazards.

QUESTION: Do you have any tips on starting the conversation? Will you please join the conversation by sharing this post via social media with your comment using #starttheconversation?

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