Earlier this year, Grand Rapids made headlines as the “best place to die” in the United States. Researchers Andrew MacPherson and Ravi Parikh of the Coalition to Transform Advanced Care used data from the Dartmouth Atlas, which tracks medical resource use, to create the list.
Interestingly, we didn’t make the top 10 in 2014. Why such a jump?
Health care is complex, so not just one thing contributed to this placement. However, one of the many reasons is better public and health care provider education, plus community-based advance care planning, or ACP.
So what is ACP?
ACP is a process — a conversation, really — to help you clarify your health care values for future end-of-life care. The conversation includes you, your loved ones, a trained facilitator and eventually your health care providers. The discussions will help you clarify your wishes regarding future medical care should you no longer be able to speak for yourself.
The conversations you have around ACP are formally documented in an advance directive, or AD. It reflects your health care values and preferences for health care, including end-of-life care. For example, what are your preferences for pain management? When would you want life-support treatment versus allowing a natural death? Would you want to utilize hospice?
The AD also appoints a patient advocate to speak for you if you are deemed unable to make informed decisions about your care. Your attending physician and another physician or psychologist must agree, in writing, that you are incapable of making informed decisions.
Many people assume their doctor or family will know their preferences for care, but that is not necessarily the case. Documenting your wishes is a gift to your loved ones, as well as yourself.
Who should complete an AD?
Everyone should complete an AD. It is a misconception that tools like an AD are only for the elderly. If your loved ones are placed in a position of making medical decisions for you, they will not have to wonder what you would have wanted in a particular situation. They will be able to advocate on your behalf to the medical community, no matter your age or stage of life.
In our state, our nonprofit offers facilitated conversations to individuals at no cost in order to create an AD. In addition, employers can coordinate with us to integrate ACP into their wellness programs. By doing so, they are ensuring their employees have discussed, decided and documented their health care wishes in advance, a key component of overall health and wellness. This key medical resource supports our city’s ability to be the best place for those at end of life.
It all starts with a conversation. Start that conversation today.