4 Questions to Guide End-Of-Life Decision-Making

How do you ensure that your loved one, when nearing the end of their life, gets the care they need and want?

It’s a difficult question, one most people would rather avoid, but will probably find they cannot.

Dr. Atul Gawande would surely be expected to know. After all, he is a professor at both Harvard Medical School and the Harvard School of Public Health, a practicing surgeon at Harvard’s second-largest teaching hospital, and he heads two public health organizations, thinking deeply about the human aspects of medicine.

His expertise and eloquence have made him an award-winning writer and a MacArthur fellow.

If anyone would know how to approach end-of-life decisionmaking, it would surely be Atul Gawande.

And yet, he himself found that he did not. Not when it came to helping his own patients, and not even when it came to caring for his own dying father.

So he put his considerable talents to use in researching the issue, ultimately publishing the bestselling book, Being Mortal: Medicine and What Matters in the End.

What did he find out? It was surprisingly simple. Just talk to the patient, honestly and compassionately, about what they want the end of their life to look like. It’s a conversation — or a series of conversations — that happens far less frequently than it should.

Gawande distilled the book into a short list of “a few important questions,” in a The New York Times op-ed entitled “The Best Possible Day”:

1. What is patient’s understanding of their health or condition?

Too often, it is too little. This may be because of cognitive decline, or because the family simply cannot bring themselves to tell the full truth to their loved one.

2. What are the patient’s goals if their health worsens?

Who could be blamed for trying to avoid this question? But if the patient is not cognitively impaired, it must be asked. Sometimes, the patient has already written an Advance Directive, colloquially known as a Living Will, stating what measures they want taken in case they are not able to speak for themselves.

But end-of-life decisions are complex; simple wishes, stated long before they are implemented, may not be relevant to the patient’s current situation. Dr. Gawande suggests that this question — in fact, all of these questions —be repeated as the patient’s health condition evolves.

3. What are the patient’s fears?

This is another question that is hard to ask — and often hard to hear the answer to.

4. What trade-offs is the patient willing (or unwilling) to make?

If the patient is of sound mind, the answers to this and all the other questions must be honored.

The questions are hard to ask, but by asking them, Gawande says, the family can “often unlock transformative possibilities.”

At Laurel Bay Health and Rehabilitation Center, in Keansburg, NJ, we offer Hospice Care with private suites, and pride ourselves on helping both the patient and their loved ones through a holistic and individualized approach.

Our meticulous care planning helps us ensure that each and every resident receives the best in clinical care, support and unconditional love.

For over 25 years, we have served the members of our community, partnering with local hospitals like Bayshore Community Hospital in Holmdel, NJ and Riverview Medical Center in Red Bank, NJ.

Read our reviews on senioradvisor.com, wellness.comand caring.com to hear what our residents and their families have to say. clicking here or by calling (372) 787-8100, and let’s discuss how your loved one can live their best possible days.

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