Advance care planning - which in Ohio includes completion of Health Care Power of Attorney and Living Will forms - empowers individuals to have a voice in their care by communicating health care choices at the end of life that reflect their ethical values and wishes. Having a written plan ensures preferences are honored should individuals be unable to speak for themselves.  Just as importantly, it saves families from the agonizing role of guessing what would be wanted during a life-threatening medical emergency.

The Institute of Medicine's recent report, "Dying in America," identifies persistent major gaps in care near the end of life and cites advance care planning as a key area requiring urgent attention. The growing number of individuals in our region who have some combination of frailty, physical and cognitive disabilities, chronic illness, and functional limitations make this study especially relevant in our community.

Goals of Care Conversations

Trusted medical professionals can - and should - play a pivotal role in educating individuals about the necessity and the process of communicating their preferences.  Unfortunately, many people do not know how to initiate conversations with their doctors or what questions to ask.  A new government ruling that has been in place since January 1, 2016, as part of the Affordable Care Act acknowledges the significance of these medical conversations by reimbursing physicians, nurse practitioners and other qualified health care professionals for having conversations with their patients during their regular check-ups.  

Providing Community Resources

The best time to begin talking and planning is well before an illness progresses to a life-threatening stage to allow time for calm and well-reasoned decision making and talks with one's family and physician. Hospice of the Western Reserve has created a booklet called "Courage in Conversation: A Personal Guide," to help families begin important conversations about end-of- life care at any stage.  It includes tips, helpful worksheets and all the legal forms required by the State of Ohio. Free copies of the booklet can be downloaded at 

Good advance planning for health care decisions is really about values, priorities and quality of life. People want to share their memories, pass on wisdom and keepsakes, connect with their families and make some last contributions to the world. Ensuring choices about end-of-life care are in place can make those moments as fulfilling as possible.