Research to Improve End-of-Life Discussions

One of my favorite blogs for eldercare advice is The New Old Age from NYTimes.com.  And, last week their post “DNR by Another Name” caught my attention.

I’ve written about DNR and POLST (Physician Orders for Life-Sustaining Treatment) on my blog before.  And, after several rounds of scheduling and rescheduling, the time has finally come for my dad and me to meet with his doctor and physician assistant to discuss the POLST form.  I’m not sure why I’m dreading this meeting so much.  Well, that’s not exactly true.  I know darn well why I’ve happily avoided this meeting.  I don’t want to discuss my dad’s end-of-life wishes because it reminds me that he/we won’t live forever.  Even writing “end-of-life” is a bit unnerving since he’s doing fine right now.

This takes me back to The New Old Age post, “DNR by Another Name” in which Dr. Amber Barnato finds that how physician’s phrase end-of-life options may impact the choice family members make. In the study adult children and spouses were given a hypothetical situation where a loved one is in the ICU with a 40% chance of dying from a bacterial infection.  When the choice was to perform CPR or “do not resuscitate”, 61% chose CPR to be administered.  When the choice was to perform CPR or “allow a natural death”, 49% selected CPR.  Both “do not resuscitate” and “allow a natural death” mean the same thing.  However, Dr. Barnato said, “it sounds kinder and gentler” to say “allow a natural death.”  Whereas, do not resuscitate evokes “the feeling of not getting something.”

I’m sure that my dad’s doctor and physician assistant will do a great job explaining the various options on the POLST form.  And, I’m sure that my dad will matter-of-factly choose the options he wants.  I need to get over my own fears and face the reality that we must hope for the best but plan for the worst-case scenario.  And, if my dad asks for my opinion I need to be very careful how I phrase my thoughts.

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