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Encouraging conversations about end-of-life care

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Lori Erickson, guest columnist

There’s a paradox in the American way of death. Most of us say we want to die at home, surrounded by those we love. Instead two-thirds of Americans die in health care institutions, often after undergoing medical procedures that were performed because loved ones didn’t know their family member’s advance wishes and doctors needed to protect themselves from potential liability.

Thankfully, a growing chorus of voices is calling for change, both within the medical community and among the general public. A national leader in this movement is physician Angelo Volandes, author of the book The Conversation: A Revolutionary Plan for End-of-Life Care.

On October 4, Eastern Iowans have the opportunity to see Dr. Volandes in person at two upcoming public events sponsored by Iowa City Hospice and more than a dozen local institutions. The first is a half-day conference geared to health professionals and religious leaders, focusing on best practices related to advance care planning. “Honoring Health Care Preferences through Caring Conversations” will be held the morning of Oct. 4 at the Coralville Center for the Performing Arts. The cost is $25. (To register, click this link).

That evening, Dr. Volandes will give a free presentation to community members, an event that’s part of the Iowa City Book Festival. (To register, click this link). He’ll talk about the need for a radical re-envisioning of the doctor-patient relationship and will offer ways for people to talk about end-of-life care with their loved ones.

These conversations aren’t easy, but they’re vitally important.

My husband and I completed our advance care planning forms last year, a process we did through the Honoring Your Wishes program coordinated through Iowa City Hospice. We consider them a gift to our children, so they won’t be forced to make decisions in a vacuum if we aren’t able to communicate our wishes to them at the end of our lives. I believe so strongly in the Honoring Your Wishes program that I serve on its board.

Every adult should have their health care preferences discussed, documented, and honored. For at the end of our lives, our loved ones may have to speak for us. And how are our children, spouses or friends able to do that if we’ve never had these conversations?

In my own life, I’ve witnessed a variety of ways to die. I’ve seen people die at home, kept comfortable by medical professionals but not subjected to invasive treatments that cause pain and distress. I’ve also witnessed deaths that left me saddened not only by the loss of a loved one, but by the unnecessary suffering they had to endure.

In his book, Dr. Volandes is blunt in his assessment of the current situation: “Americans receive some of the best health care money can buy; they also experience some of the worst deaths in the developed world.” He believes that this situation can change, if enough people get behind the movement for advanced care planning.

Every adult, not just people with a serious illness or the elderly, should be having these conversations. Dr. Volandes is offering us a rare opportunity to hear firsthand about national efforts to fix a broken system of health care for the dying.

l Lori Erickson serves on the board of Honoring Your Wishes, a program of Iowa City Hospice.

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