A new proposal might encourage more Missourians to have that talk. Lt. Gov. Peter Kinder plans this summer to roll out a plan similar to the program at Gundersen Lutheran Hospital in La Crosse, Wis., where more than 90 percent of the patients have signed advance directives. Advocates say results include less expensive and more satisfying end-of life care.
Bud Hammes, director of the Respecting Choices training program at Gundersen Lutheran, said the end-of-life care model began in 1986 with dialysis patients, who are at high risk for strokes that can severely impair motor skills and brain function. Hammes kept having the same difficult discussions with family members in case after case about whether the loved one would like to continue receiving dialysis to prolong his or her life.
“I repeatedly got this look of despair and the response of, ‘If I only knew,’ ” he recalled.Hammes said he was surpised that dialysis patients were visiting the hospital three times weekly for hours at a time and no one bothered to ask what type of care they’d like should they become incapacitated.
Over the years, advance care directives have become a communitywide passion in La Crosse. The discussion is built into the hospital’s admissions process. From primary care doctors to emergency rooms, patients are given the opportunity to make end-of-life plans. At Gundersen Lutheran, advance directives are part of a patient’s electronic medical records, viewable by medical care personnel from paramedics to the bedside nurse.
Paula Span ponders the reasons why more people do not have advanced directives at The New Old Age Blog.
