February 24, 2014

Discussions about health care reform often cite prevention as a way to improve health and reduce costs. However, these conversations often fall short when it comes to end of life.

Talking about the end of one's life is now becoming more standard. Patients are becoming empowered to speak up about their goals and wishes. End-of-life decisions have significant emotional and financial consequences. Nearly one-third of Medicare's half-trillion-dollar budget is spent on the last six months of patients' lives. Studies show advance planning lowers these costs and reduces the emotional burden on families who try to guess what loved ones want. Health care proxies guess wrong about 60 percent of the time.

Setting a Standard for End-of-Life Care

Because there is no best practice for initiating end-of-life planning conversations, timing varies based on a doctor's experience and beliefs. Now, a new initiative by Hospice of Cincinnati called Conversations of a Lifetime, encourages earlier planning between physicians, patients and families.

This initiative equips physicians with skills to initiate and continue end-of-life conversations. They enable everyone to express what's most important in terms of treatment and quality of life, and give providers an easier way to honor these wishes.

Engaging the Community

Pilot efforts underway at TriHealth will develop a new best practice for end-of-life planning. This includes enhancing electronic medical records with advance care planning forms in order to document end-of-life wishes. Trained staff will help families make these important decisions.

To help all of us become more "conversation ready," Hospice of Cincinnati is reaching out to physicians, hospitals, long-term care facilities and the community to normalize end-of-life conversations. for patients and their families. Taking a proactive approach to end-of-life planning will be the new community norm.

National Health Care Decisions Day is April 16. Take this opportunity to have a conversation-and make advance care planning a part of your life.

John Prout, president and CEO, writes about current health care issues in his monthly series, A Healthy Perspective.