Honoring Choices: Preparing an end-of-life care plan
The Kittitas County Medical Society (KCMS) supports the recommendation that all adults in Kittitas County have a complete advance end-of-life care plan. To accomplish this, the KCMS would like to support the Honoring Choices program, an initiative of the Washington State Hospital Association and the Washington State Medical Association.
The purpose of increasing the number of adults with comprehensive advance end-of-life care plans is to improve quality of end-of-life care for patients and their families and to ensure that the wishes of patients are met when they may not be capable of making decisions in the moment (for example, due to illness, dementia or unconsciousness). This also removes the burden of decision making from loved ones, reducing family stress and the chances that medical measures are taken which are against patient wishes. Furthermore, comprehensive advance end-of-life care plans allow for a reduced length of stay in hospital and frequency of hospital care encounters. This planning can increase the longevity of hospice services, which translates to more time at home.
Perceived barriers to implementing this plan include limited community awareness of the program, insufficient numbers of trained clinic personnel to facilitate discussions with patients and families about end-of-life care planning, and cultural taboos regarding chronic disease and mortality. The Honoring Choices program is addressing some of these barriers, however, and the KCMS is not attempting to duplicate the program.
The KCMS encourages local physicians to identify a member of the care team at each clinic who would be suitable to facilitate advance end-of-life care decision making conversations to undergo training with the Honoring Choices program when a local trainer is made available.
We also recognize the importance of engaging local culture to lift taboos around death and dying and allow for open discussion. Concepts relating to mortality and what constitutes a good death are of highest importance to prioritizing, defining and living a good life. To open these discussions, the KCMS proposes to support local events which involve education regarding death and decision making and avenues which inspire engagement and discussion of this important topic.
The proposed timeline to implement the first stages of this plan is one year. During this time, as the local implementation of the Honoring Choices program proceeds, further revision of this plan will likely be necessary in order to support the changing needs of the community.
For further information regarding the Honoring Choices program, see their website at http://honoringchoicespnw.org — resources to begin the process of discussion and planning are available under the “Get Started” tab at the top of the webpage.
Clint Thompson, DO, is a resident physician at Community Health of Central Washington in Ellensburg.
Originally posted on dailyrecordnews.com