Recognizing the Conversations

Advance Care Planning (ACP) conversations don’t typically appear with headings and paragraphs and categories. They appear in the midst of life – whether it be a brief aside during a movie, a comment about the importance of pets in our life, or significant words exchanged with family members during the healthcare crisis of another family member. These conversations can be short or long and can happen with individuals of any age or health status. Have a look at these statements – which of them fit into the category of ACP?
1. “This little dog is the best thing that ever happened to me. I often wonder how I got along without him.”
2. “I just can’t stand being in confined spaces.”
3. “Harry is in a nursing home now and they have to spoon feed him. Sheila cries every time she visits him – so much so that her kids wonder if they should limit her visits.”
4. “I think the idea of defibrillators in sports arenas is a great one. In fact, every time I go to a hockey game and pass the defibrillator on the wall, I feel good that help would be so close at hand.”
5. “I get the most pleasure out of seeing her smile and having her squeeze my hand.”
6. “I watched as her minister prayed with her. She seemed to get such comfort from that prayer. I hope someone will pray for me that way when I’m dying.”
7. “I have written out my wishes for future care on a piece of paper.”
Of course all of these comments have something to do with ACP. They communicate values and beliefs and concerns about health and general well-being. They aren’t legal documents, but they are important guidelines for delivering care to an individual when that individual is too ill to make decisions for themselves.
So let’s stop looking for formal conversations alone to guide us as we agree to treatment for and deliver care to our family members who can no longer decide for themselves. Let’s jot down snippets of conversations, let’s recall ways in which these individuals lived their lives, and let’s use this information to inform our decisions for them. The goal should be for us to do just what the person would have wanted us to do, in light of their values, goals, and beliefs.
Take a moment to view this brief commentary by Joanne Lynn, Bureau Chief for Chronic Diseases and Cancer in Community Health Administration of the Department of Health for Washington, DC. Joanne is a leader in ACP and sheds light on the breadth of these ACP conversations.
http://www.youtube.com/watch?v=OOH5hVQRxD4