Apr 22 2014
Henry Ford Health System is embarking on a major initiative over the coming year to inform its patients about "The Conversation" - an often daunting and uncomfortable discussion of advance planning for death and dying.
The initiative is part of an ongoing nationwide project aimed at helping individuals and families prepare for a loved one's final wishes before fatal disease or dying forces the issue under stress and emotional strain.
"The Conversation" is meant to take place even before the drafting of an advance directive that legally spells out what health care actions and limits an individual wants if he or she is unable to make decisions because of incapacity, serious illness or death.
"Any of us in health care has seen families huddled in hospital hallways having emotionally wrenching, sometimes heated last-minute discussions about making a life-or-death decision for a critically ill loved one," says Kimberlydawn Wisdom, M.D., Henry Ford's senior vice president of Community Health & Equity and chief wellness officer, and a co-leader of the new Henry Ford initiative.
"Having 'The Conversation' well before such a decision has to be made can allow families or friends to simply grieve at such a terrible time, without having to guess or disagree about their loved one's own final wishes."
Henry Ford has created a website, www.Henryford.com/AdvanceCarePlanning, to help facilitate the delicate task of talking through and reaching an informed decision about end-of-life issues.
The material, including checklists and worksheets as aids in taking on the delicate task, is in keeping with "The Conversation" Project, a nationwide grassroots movement co-founded in 2010 by Pulitzer Prize-winning syndicated columnist Ellen Goodman after her mother's death.
It happened without clear instructions from Goodman's mother about her end-of-life care.
"The last thing my mom would have wanted was to force me into such bewildering, painful uncertainty about her life and death," Goodman wrote afterward. "I realized only after her death how much easier it would have all been if I heard her voice in my ear as these decisions had to be made.
"If only we had talked about it. And so I never want to leave the people I love that uneasy and bewildered about my own wishes. It's time for us to talk."
Henry Ford's initiative is being launched after months of planning to prepare its administrators, medical staff and health care operations for advising patients about "The Conversation" and enabling end-of-life preparations for themselves and others. "Simply put, this project is to get people talking about their final wishes before it's too late," Dr. Wisdom says.
The Henry Ford initiative recognizes that although advanced directives in their various forms are widely advocated as a means to communicate end-of-life preferences, few people complete them.
In addition, technological advances, availability of life support, general literacy and health literacy challenges, as well as cultural preferences have significantly deepened the complexity of such decision-making.
To meet some of those challenges, Henry Ford designed its initiative with input from Detroit-area civic leaders, faith-based organizations and others who will participate in spreading the word about "The Conversation."