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Op-Ed: Talk Turkey About Healthcare Directives This Holiday Season

One of the best gifts parents can give their children is explicit instructions about their end-of-life care.

As a nurse, I see time and again what happens when families come together at the bedside of a seriously ill parent without ever having planned -- or even discussed -- end-of-life decisions.

These decisions are wrenching enough. But when the dying parent has given his or her children no guidance the situation can be far, far worse. I have seen one adult sibling say mom would have wanted “everything” done, while another says mom would never want to live with a feeding tube or ventilator.

The conflict can tear a family apart at a time they need to come together. That's why I tell our nursing home residents -- and everyone I know -- that the best gift you can give your children is knowledge of your end-of-life wishes.

Tell your loved ones want you want. Then put it in writing.

Our nursing home, Royal Suites Healthcare and Rehabilitation, is part of the Atlantic-Cape Community Coalition, which includes AtlantiCare Regional Medical Center, AtlantiCare Healthcare at Home, Shore Medical Center, Cape Regional Medical Center, and other area nursing homes. Also part of our coalition is Healthcare Quality Strategies Inc., the state's Medicare improvement organization.

During this Thanksgiving season, the coalition is coming together for a program we're calling, “Let's Talk Turkey.”

We are working to educate the public about healthcare planning and advance directives and encouraging families to start the conversation – to “talk turkey.” Families gather for this holiday, and I believe there is no better way to express your love than to start the conversation. Relieve your family members of the task of trying to fathom your wishes if you can no longer make decisions for yourself.

A friend of mine recently had the conversation with her father. Thinking of life without her dad sent her home in tears. These are not easy discussions. But just think of the tears that may be eliminated in the future. My friend will not have to endure the burden of trying to decide what her father would have wanted. Instead, she will carry out the decisions her father has made for himself.

The number of Americans with advance directives is steadily increasing. Still, just 29 percent of Americans now say they have a living will, according to a poll by the Pew Research Center for the People & the Press. The number is double the number in 1990, but still far too low.

Drafting an advance directive is not complicated and does not require a lawyer. Forms for the state of New Jersey are available online. They can specify if a person wants – or does not want – to live with a ventilator or feeding tube if physicians believe their illness is incurable and there is no chance for meaningful recovery.

There are many misconceptions about advance directives. A living will does not mean a person gives up all treatment or even any treatment options. My living will says that I would want antibiotics or cardiac medications if they would help my condition, but I do not want a feeding tube if I am dying. Very often these medical interventions do not keep us alive longer but merely change the way we will die.

This weekend, as you gather with family, bring up the conversation – maybe while you are stacking plates in the dishwasher, or passing around the pie. The conversation may not be as much fun as chatting about the football game. But not talking about these decisions will not prevent the need for answers someday in the future.

Diane Conover, RN, is a registered nurse at Royal Suites Healthcare & Rehabilitation in Galloway, NJ.

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