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Nurses Can Be Pivotal in Advance Care Planning
Most people agree that we all should have the power to make our own health care decisions. Ironically, most Americans have not taken steps to make sure their wishes are known or honored. A recent study by the Pew Research Center for the People and the Press found that, although more than 70 percent of Americans had given thought to end-of-life treatments, only 29 percent have a living will. Nurses are in a unique position to change that.
What are Advance Directives?
Advance directives (sometimes called living wills) tell health care providers what kind of care a patient would like when he or she is not able to communicate with care providers. These directives can address what medical care and which treatments a patient does or does not desire, and under which circumstances — usually depending upon the severity of a condition and prognosis. An advance directive also includes a “Health Care Power of Attorney,” a document that tells the health care team who can make decisions on the patient’s behalf, if the patient is unable to speak for herself or himself. Laws about advance directives and healthcare powers of attorney vary from state to state. As a nurse, you can greatly help your patients by being familiar with the laws in your state.
What is Advance Care Planning?
Advance care planning is important whether the patient wants every life-sustaining intervention available, or whether she or he prefers to live the final period of life focused solely on comfort care. What matters is that the patient’s wishes were made known to loved ones by completing a written advance directive. Without this planning and communication, family and health care providers may not know how to honor a patient’s wishes and values.
How Can Nurses Provide Support?
Nurses can play a pivotal role with families and patients in helping them understand and personalize the information they receive about their health care status. Nurses can help families by interpreting the significance of patients’ symptoms, by locating and sharing educational resources to aid in decision-making, and by supporting both patients and families when difficult decisions have been made.
For those with life-limiting conditions, information about treatment options, chances of cure, remission or prognosis is never easy to hear. Patients absorb and process this information in their own ways — and in their own timeframes. Regardless of how well everything may have been explained the first time, it may be beneficial or necessary to review information again with the patient and family. Nurses can assist with this explanation and can often clarify questions patients and families may want to ask their physicians.
If you would like more information on how to talk to your patients about advance care planning, visit the National Hospice and Palliative Care Organization website at www.caringinfo.org and click “Advance Care Planning.”
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