National Healthcare Decisions Day is celebrated on April 16th each year to inspire, educate and empower the public about the importance of advance care planning. Advance care planning starts with expressing wishes, clarifying values, identifying health care preferences and selecting an agent to communicate healthcare decisions if you are unable to speak for yourself. You don’t need to wait for a physician to begin the conversation– conversations can get started in the privacy of your own home and on your own timeline.
The important thing is to start thinking, and then start talking. Begin by having a conversation with those closest to you. Take the time to consider “what matters to you” at the end of life. “Advance Directives” are legal documents (Living Will and Healthcare Power of Attorney) that allow you to plan and make your own end-of-life wishes known if you are unable to communicate. Formally documenting your decisions doesn’t mean you cannot change your mind, and your plan, as your circumstances change.
Initiating these conversations with families, both your own and others we serve, can be difficult. Dealing with emotion is often necessary for effectively discussing decisions. When individuals express strong emotion, it is helpful to actively listen. The framework N-U-R-S-E-S, created by VitalTalk®, can be used to acknowledge and attend to emotion:
Name – Acknowledge the emotion, then pause. Ex. “I can see this is making you feel concerned/anxious.”
Understand – Acknowledge the emotion or situation. Ex. “This helps me understand what you are thinking.”
Respect – Express praise or gratitude about things the patient/family are doing. Ex. “I appreciate you taking the time to have this difficult conversation with me.”
Support – Express support and affirm non-abandonment. Ex. “We will do everything we can to support you through this process.”
Explore – Ask a focused question from a place of curiosity. “Could you say more about what you mean when you say…?”
Silence – Use silence intentionally to show presence.
Written by Laura Alexoff, Advance Care Planning Liaison, and Stephanie Leung, Project Specialist, Advanced Illness Programs