Discussions of death are uncomfortable, but necessary

What if ….

You had less than 12 months to live because of illness? Would your health care providers provide an honest appraisal of your prognosis, or tell you all about the possible (very lucrative) interventions that might possibly extend your life for another 12 months, but decrease its quality?

What if you were not conscious or sentient? Who would make the decisions? Would they be emotionally comfortable with saying “no” to intrusive interventions, if those were your wishes? How would they decide if they had no knowledge of your wishes?

These are not abstract questions. Every year, 2.5 million Americans enter the last year of their life. There are legal documents — advance directives — by which you can avoid unwanted care in case of serious illness and/or designate a decision-maker, but only about 35 percent of all Americans have implemented these.

Even if people have thought about how they would like to die, it can be difficult to have a conversation with loved ones about those choices.

But those who have implemented advance directives have done so in fact to spare loved ones from the emotional (and potentially financial) burdens that may come with treatment decisions. Absent that information, long-term partners may not accurately know what is desired, and decisions become based on emotion. Most people who implement advance care planning choose to emphasize independence and quality of life over living longer.

Those decisions are supported by evidence that a better quality of life in advanced cancer patients occurs if they are not hospitalized and have supportive family, friends, and ministers close at hand.

Many of us have stories related to this. Here are a couple of mine. My father was diagnosed with advanced lung and liver cancer 35 years ago. His doctors were enthusiastic about treatments. But a “good day” was when he could sit up and talk for 20 minutes during a day.

We never talked about how long he wanted to prolong his life. So when my mother called me down at 2 a.m. after he had slumped over and the EMT arrived, I had 5 seconds to think about my answer to their question: “What do you want us to do?”

I think I made the right decision, but agonized for years over not knowing what he wanted. I’ve told my wife that if I need extensive caretaker help, I prefer to be moved into a facility, as we watched how my father-in-law’s physical and mental condition deteriorated over the years of being the caretaker for his wife.

But there remain many more things to convey to my wife and son.

To help all of us think about these decisions and conversations, Laurie Jackson, senior director of Compass Care in Yakima, will speak to us.

Her formal education includes a Masters of Divinity and a Masters Certificate in Clinical Ethics; her vision is to remove the fear of end of life.

In her work as a leader in hospice and palliative care, she has focused on advance care planning, primarily teaching on The Five Wishes, and began the work to standardize The Surprise Question. Please join us for what may be an “uncomfortable” hour for you, but one that may ultimately provide great comfort for your loved ones.

The Columbia Basin Badger Club is a nonpartisan Tri-City organization that is dedicated to civil discourse on topics important to our region.