National Healthcare Decisions Day: Your decision matters


National Healthcare Decision Day 2022

National Healthcare Decisions Day was observed April 16. The observance was established to educate the public and medical providers about the importance of these thoughtful decisions. It is a day dedicated to having meaningful conversations about goals of care and making decisions about your advance care plans.

“Although this day brings the importance of advance care plans to the forefront, this topic can be addressed any day of the year,” says Charles Crecelius, MD, BJC Medical Group Post-Acute Care Medical Director.

“By putting your advance care plan in writing for your loved ones and your medical team, patients can ensure their wishes toward end of life are carried out if they cannot speak for themselves,” Dr. Crecelius says.

According to the founder of National HealthCare Decisions Day, Nathan Kottkamp, a Virginia-based health care lawyer, the April 16 date was chosen because it is the day after Americans file their tax return, building on the old-adage that there are two things certain in life, death and taxes. “The day after your taxes are due,” says Dr. Crecelius, “think about your health care decisions.”

“About 90% of us will not die suddenly and will go through a long process of decline in physical and mental abilities,” says Dr. Crecelius. “Some may want every medical intervention, no matter how much pain, suffering or functional loss they go through, while others do not want any extraordinary measures done, such as shocking the heart or even going to a hospital. Many are somewhere in between.”

Although it may be uncomfortable, it is important for family members to discuss these decisions at a time when all are able to communicate and process loved ones’ wishes. “As we age, many of us will lose the ability to be involved in important health decisions due to mental, cognitive or psychologic losses, and in those cases, we will have to depend on our loved ones to make difficult decisions,” he adds.

Studies have shown loved ones often do not really know what their loved one wants, as they never took the time to seriously discuss their goals of care and put them in writing. Goals of care are not just about what you want today, but more importantly what you would want if you got very sick and were unable to speak for yourself. Goals of care can include things like still being able to talk with family, to participate in the hobbies you love, to attend religious services, to be independent in bodily functions and similar personal lifestyle issues.

“Knowing what is important in life to you lets you have a voice in your future health care, even when you can no longer speak for yourself,” Dr. Crecelius says. “Life can be unpredictable. The truth is that none of us knows how much time we have left. It’s a tough conversation to have — and arguably an even tougher action to undertake — so sooner is better than later.”

Engaging with family members or loved ones is crucial. “It starts with an honest conversation with your loved ones, thoroughly discussing your medical wishes for the end of life. Studies show that more than 90% of us think this is an important thing to do. But alarmingly, less than one-third actually create an advance directive — the document that puts a plan in place and designates a loved one as your health advocate.”

In the absence of an advance directive, medical personnel rely on your loved ones to determine what your wishes might be, and loved ones often struggle to make these difficult decisions in crisis situations.

Currently less than 10% of patients over the age of 65 have any documentation of living wills, power of attorney documents or other advance care documents in their BJC medical records. Even at death, only 34% have any document expressing their wishes.

An advance care plan prepared before an urgent or emergent situation occurs removes the burden from loved ones and allows a better sense of certainty that individual wishes can be honored.

“Everyone has unique circumstances, and your loved ones and health care team should fulfill your wishes toward the end of your life,” Dr. Crecelius says. “This is about what you want, and not what anyone else wants for you.

“We can all start this process by acknowledging the importance of goals of care and advance care planning on National Healthcare Decisions Day. On this day or any day, you want to be sure you have a voice in your future health care.”

If you are a BJC HealthCare patient and have a MyChart account, you can prepare for your care and have a voice in your medical care by talking with your doctors and filling out an advance directive form to put your wishes in writing. Learn more about advance care planning.

More about advance care planning

According to the National Institute on Aging, advance care planning is not just about old age. At any age, a medical crisis could leave you too ill or injured to make your own health care decisions. Even if you are not sick now, planning for health care in the future is an important step toward making sure you get the medical care you would want.

What is advance care planning?

Advance care planning involves learning about the types of decisions that might need to be made, considering those decisions ahead of time, and then letting others — both your family and your health care providers — know about your preferences. It’s a way to help your loved ones and doctors make health care decisions for you if you can't speak for yourself. Talking about your values, preferences and beliefs will help make your wishes clear.

Why it is important?

You have a right to make decisions about your medical care. But in a time of crisis, you may not be able to speak for yourself. One out of every three people will need someone to make decisions for them at some point. It’s best to be prepared.

The basics of advance directives

An advance directive explains your wishes for end-of-life or critical care. It includes two types of legal papers:  a living will and a durable power of attorney.

Living will

A living will speaks for you when you cannot speak for yourself. It shows your choices for health care when you’re not able to speak for yourself. It helps when hard decisions have to be made. Your family and doctors will know exactly what treatments you would and wouldn’t want. Be sure to update your living will on a regular basis.

Health care durable power of attorney

This is a legal document that gives someone the power to carry out your medical wishes. The person you choose is known as your agent. Your agent can be anyone who:

  • Knows you well

  • Understands what choices you would make

  • Can talk with your loved ones about your care

  • Will make sure your wishes are carried out

Questions to ask yourself:

  • Would you want to have a machine help you breathe?

  • Would you want treatment to keep you alive no matter what condition you’re in?

  • Would you want to be brought back to life if your heart stops?

Learn more about advance care planning.

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