Making decisions about advance care planning
One of the hardes decisions chronically ill patients and their families' face is one regarding their preferences for care as they approach end of life. It can be difficult for them to determine if medical treatment should be continued and if so, for what length of time. Other concerns that often cloud decision-making include the uncertainty of the treatment's success, the patient's overall prognosis, and their quality of life with or without treatment. Many patients rely on the guidance of their physicians to help make the right choice for them.
It's important to have open and ongoing discussions about end of life care becuase, as the patient's condition changes, so might their decisions. By obtaining realistic information regarding prognosis, treatment options, and the how the progression of the illness will impact daily activities, patients have a clearer understanding about what lies ahead and can make their decisions accordingly. Surrogate decision makers are also encouraged. Should the patient become incapacitated and bot be able to communicate his or her wishes, a surrogate who has maintained close communication with them will be able to speak on their behalf.
At a time when patients and their families are struggling with the inevitable realities that go hand in hand with end of life, advance care planning can provide some much needed comfort and peace of mind.
Gregory C. Gifford, MD JD Chief Medical Officer
Board Certified in Hospice and Palliative Medicine