Thursday, December 4, 2014

It’s the Holidays, Can we Talk?

By: Craig Greer, Director of Special Programs at Comfort Care Home Health and Hospice

The holidays are upon us. It’s a time for family and friends, sharing memories and bonding in the midst of celebrations and gifts. But the greatest gift loved ones can provide and receive is peace of mind. How can we provide another with peace of mind - by talking about life and healthcare choices.

Stephen Covey, author of Seven Habits for Highly Effective People talks about beginning with the end in mind. For each of us, our lives will eventually end in death. Not a happy thought, but a true fact that we cannot deny. Somehow we avoid discussing this reality until there is a crisis.

As a chaplain, I have held hands with family members and heard the same sad theme time and time again. “I know what I would want, but I don’t know what mom would want,” as they agonize over difficult decisions about ventilators, feeding tubes, palliative care or hospice. No matter the decision in these situations, there is no peace of mind.

The time to talk about end-of-life care options is when we are healthy. To do so after a diagnosis is more difficult because of the fear and anxiety. This doesn’t mean it is easy to have this conversation, but it is easier after topic has been introduced and there has been talk about the types of care a loved one prefers. Certainly we may change our minds when a diagnosis occurs, but the fact that there has been discussion makes it easier to revisit our decisions and modify as necessary.

Important decisions for those 19 years old or older can be achieved by pondering the following questions: Who would speak for you if you could not speak for yourself? What types of care would you want to receive if there was less than a five percent chance of meaningful recovery? What does meaningful recovery mean to you? It is critical to have this discussion with your healthcare proxy, so he/she will understand the responsibility involved.

The next phase is discussing options if you have a chronic or debilitating disease. It is important to fully comprehend the diagnosis and how the disease might progress over time. For example Congestive Heart Failure and pulmonary diseases typically don’t improve - these conditions worsen over time and often require frequent hospitalizations. Likewise cancer treatments can cause many side effects that may be intolerable. At what point is it enough? How would you want to live your life? Where would you want to receive care? There are options and you do have choices.

There is no right or wrong answer. It is crucial for all of us to reflect on our values and beliefs in order to come up with a plan and we should talk with all of our loved ones in order to make our wishes known. How can loved ones honor healthcare decisions when they don’t know what those decisions are?

We think of this primarily as a legal issue, but it is also a conversation issue. We must have the talk with our loved ones and then put our wishes down in writing as a last step.

For the past two years Comfort Care Hospice has worked to promote this conversation in our communities for people of all ages. There are many great grass-roots programs to help people navigate this difficult topic. For a list of resources visit our website

If you would like more information about our community events or to have someone to talk to your group, please contact

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