Download presentation
Presentation is loading. Please wait.
Published byMarybeth Tyler Modified over 6 years ago
1
Straight talk! An open and honest conversation about dying…
Ann Jackson, MBA Oregon Hospice Association October 26, 2007 2007 Statewide Training Conference RAP/CHAT Volunteers
2
About me… 20 years as director of Oregon Hospice Association
MBA in nonprofit management Published in NEJM and other medical journals Speaker re EOL care in Oregon Member of Oregon and national task forces re hospice and EOL Hospice caregiver in 1996
3
Oregon Hospice Association
Public benefit, charitable membership organization and accrediting body for hospices Dedicated to ensuring that all Oregonians have high quality hospice and palliative care Participates in research about end of life care in Oregon Supports open and honest conversation about all end of life choices Encourages opportunities to speak on behalf of Oregon and Oregon’s hospices Addresses concerns about hospice and palliative care in all settings
4
Americans are planners!
Careers Weddings Families Vacations Retirement
5
Except… About the end of life Forcing others to take over when we’re
Most vulnerable Most in need of understanding and comfort Most longing for dignity From “End of Life Decision-Making” Family Caregiver Alliance
6
Objectives Outline issues we need to think—and talk—about
Talk openly and honestly about anything Identify resources that can help in Oregon Advance Directives POLST Discuss strategies for grieving—for ourselves and for residents
7
Why is it so hard to talk about dying?
Don’t want to think about it Threatening Fear of taking away hope Insensitive Culturally insulting
8
When we do talk about dying, what do we say?
“Didn’t make it” “Passed away” “Put to sleep” “Gone to heaven” “Kicked the bucket”
9
..And what do our doctors say?
“There’s nothing more we can do.” This is never true!
10
What are your rights at the end of life?
pain relief refuse treatment stop eating and drinking make wishes known in advance hospice and “palliative” care physician aid in dying in Oregon
11
Oregon’s Death With Dignity Act
Add experienced-based information to data void Not defend ODDA Not debate whether assisted dying—or hastening death—is right or wrong
12
Assisted Dying: A Legal Option in Oregon
No longer matters whether physician- assisted dying is right or wrong Allowable in state Dying Oregonians eligible for both hospice and ODDA
13
Provisions of ODDA Allows terminally-ill adult to request prescription for self-administered lethal medication Prohibits euthanasia “Physician-assisted suicide” accepted term to describe provisions of law Ending life is not suicide under Act
14
Patient Requirements Oregon resident 18 years of age “Capable”
Able to make and communicate health care decisions Terminal illness with 6 months or less to live Request must be voluntary
15
Perspective 270,000 Oregonians died between 1998 and 2006
292 used physician-assisted suicide 269,708 did not
16
Patient Concerns
17
Why do so few Oregonians use assisted suicide?
Because most reasons people give for believing assisted suicide should be legal can be “fixed” in ways that Require no additional legal sanction Practiced throughout country Dying Americans can choose from among all
18
What are your choices? Control pain and other symptoms
Refuse or withdraw treatment Seek hospice and palliative care Make decisions in advance Appoint health care power of attorney
19
Who should you talk to? Friends and family members Your doctor
Be open and honest about your concerns Your doctor Tell him or her how much you want to know about your illness, your prognosis, treatment options, and hospice
20
What should you talk about?
Who will make decisions for you? What care would you want? Or fear? Do you want to be resuscitated? Do you want to go to the hospital? How will your care be paid for? What is covered by your insurance? What happens when a person dies?
21
What are advance directives?
Written instructions that communicate wishes about care and treatment Living will Medical power of attorney Health care representative, agent, proxy or surrogate
22
Why do you need an advance directive?
So that medical personnel and your loved ones will know what you would prefer if you are unable to speak for yourself So that medical personnel will know who can speak for you if there’s disagreement
23
What care may be included in an advance directive?
Artificial feeding Mechanical ventilators CPR Antibiotics Dialysis Other invasive procedures
24
What other instructions might you include?
That you do not want life-prolonging treatments if you will never recover your physical or mental health That you do want your life prolonged as long as possible
25
What you would want under certain conditions
if you have dementia if you’re in a coma if you have advanced disease That you’d want comfort measures or hospice
26
What happens if you don’t make your wishes known?
Default is that everything will be done to keep you alive Family members and friends will undergo the stress of having to make decisions on your behalf without knowing what you would have done
27
An advance directive is a “gift” you can give your loved ones
28
What are we afraid of? Hospice addresses fears people give for wanting physician-assisted dying Dying in pain Dying in the hospital Being hooked up to machines Being alone Being a burden Losing control Only in Oregon may people have both both hospice and physician-assisted dying
29
People have nothing to lose in hospice care!
“Win-Win” If patient doesn’t like hospice care he or she can quit If patient gets better, he or she will be discharged…
30
What we don’t know can hurt us!
Give doctors “permission” to be open and honest—and to tell the truth
31
Discussion
32
Resources Medicare Hospice Benefit
Links and resources about end of life care Advance directives for every state
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.