Towns Join Effort to Get People to Start Talking About End-of-Life Issues

Andrew Kitchenman | April 17, 2015 | Health Care
‘Conversation of a Lifetime’ initiative aims to address difficult topic at grassroots level

Princeton Mayor Liz Lempert
While Princeton Mayor Liz Lempert supports public-health initiatives, she admits she was a little hesitant when she first heard about a proposal to have mayors promote community conversations about planning for end-of-life healthcare decisions.

But while it can be an uncomfortable topic, Lempert said, town officials are well-positioned to make a difference.

“Because it’s a difficult conversation, this is really what a community is for: to help each other to address difficult topics,” Lempert said.

Princeton is one of three municipalities, along with Gloucester Township and Tenafly, selected to launch ”Conversation of a Lifetime,” that will organize community events to encourage people to document their end-of-life wishes.

The initiative is being sponsored by the Mayor’s Wellness Campaign, an initiative of the New Jersey Health Care Quality Institute, a nonprofit dedicated to improving healthcare quality while containing costs. The goal is to expand the program in the future.

“Most of the time, we want to be talking about exciting, fun things that are happening in the community,” Lempert said. “And this is really a daunting conversation to have. Most of the time, we don’t want to be thinking about our own mortality and our own death.”

The issue is of particular importance in New Jersey, which leads all states in healthcare spending and in the number of visits to medical specialists in the last two years of life.

State Health Commissioner Mary E. O’Dowd has made planning for end-of-life healthcare decisions a priority, including promoting a new form – called Practitioner Orders for Life Sustaining Treatment (POLST) — that has the legal force of a doctor’s order when it comes to decisions about whether to put a person on life support.

New Jerseyans “often spend those final months in a hospital or in a clinical setting that they would prefer not to be in,” O’Dowd said at the official launch of “Conversation of a Lifetime” yesterday at the Princeton Public Library.

She added that, for many people, their priority in their final months is to be “free of pain, in familiar surroundings with family and friends, instead of in a facility-like setting.”

[related]Last year, a Monmouth University-New Jersey Health Care Quality Institute poll found that 81 percent of New Jerseyans said they would be comfortable talking about end-of-life medical care planning with a family member, but only 45 percent had put their wishes in writing.

NJHCQI Vice President Linda Schwimmer said the goal of the new initiative is to bring those two numbers closer together, to ensure that people’s final wishes are followed.

“What we’re trying to do is to change the culture here in New Jersey, to make people become more comfortable with actually starting the conversation and then taking that next step, to putting their wishes in writing,” she said.

Lempert said a broad range of volunteers will participate in the “Conversation of a Lifetime” effort.

“We all want to do right by one another, and when there’s not clarity and you don’t know, it can lead to a lot of guilt and make a difficult time even more difficult,” she said.

Shelly Hawk, a program associate at the library, has become a vocal proponent of end-of-life planning. Her mother died after a three-year battle with lung cancer that metastasized in her brain before she had expressed her end-of-life wishes, while her 42-year-old brother died as a result a brain aneurysm, without completing similar planning.

“We’re all guessing and wondering if what we did for our loved ones was the best thing,” she said.

Hawk said she began yesterday, which was designated National Healthcare Decisions Day, by emailing family members about their end-of-life planning.

“We need to talk about it as a community, and as a country and as a world — it needs to be talked about and planned for,” she said.

“Conversation of a Lifetime” will include events to be held in all three communities over the course of the next year, include film festivals, seminars and other activities tailored to each town.

More information about advanced-care planning is available at the state Department of Health website.