Discussing End-of-Life Care With Your Physician

While most adults prefer to receive end-of-life care in the comfort of their home, a recent study found only about one-third of Medicare beneficiaries age 65 and older die at home. Discussing end-of-life care early with a physician, rather than near the very end, could help ease the pain for patients and their loved ones.

Doctors of Osteopathic Medicine, or DOs, are trained to look beyond your symptoms and take the time to get to know you as a whole person. They also partner with you to make decisions about your health.

The first step to quality end-of-life care is sharing a vision of what constitutes a “good death” with a physician. It might be challenging to ask an ill parent or loved one to discuss their wishes for end-of-life care but, in reality, they might be waiting to be asked, says John Bertagnolli, DO, an osteopathic hospice and palliative care physician and an assistant professor at Rowan University School of Osteopathic Medicine in Stratford, New Jersey.

“My patients tell me they have a fear of suffering, of being in their body but not able to control what happens to them. DOs are trained to work with patients at the end of life to control pain and to give them the comfort they deserve as their life comes to an end,” Dr. Bertagnolli explains.

5 Ways to Die On Your Own Terms

Expressing your wishes or encouraging loved ones to share their intentions helps take the decision making burden off the family and physician.

“It makes the decision rational because everyone knows exactly what the patient would want, which gives the dying person peace and control,” Dr. Bertagnolli says.

Here are five ways to initiate the process for yourself or a loved one in your care:

1. Partner with Your Physician—When you (or a loved one) know what you do and don’t want to happen, your physician can explain which interventions might aid or interfere with your plans. Having the discussion with your physician while family members are present can make it easier to talk about an uncomfortable topic.
2. Talk to Your Loved Ones—Families understandably don’t want to let go and may want to try “one last thing” in hopes of preventing a loved one’s death. Keep them from struggling with decisions by letting them know what you’ve decided. Integrating your or a loved one’s physician into the conversation may help your family recognize and respect the decisions.
3. Put it in Writing—Some states offer legally binding documents that serve as medical orders for those with limited life expectancy. These orders were developed to prevent patients from receiving medical treatment inconsistent with their wishes. These documents also ensure that you or a loved one will receive medical treatment consistent with end-of-life wishes.
4. Manage the Details—Help your family take care of you by putting advanced directives in place, giving legally binding power of attorney to one or more people so they can follow through on your wishes. Also, you should finalize your will. Research all of the financial institutions that you do business with in case they require additional documents.
5. Identify and Implement Goals—Identify the life experiences you would like to have before you die, from visiting a city to seeing a child graduate. Share those goals with family and friends and ask for their help realizing your final wishes. Ask loved ones in your care about their life goals and how you can help achieve them.