Aging Well

Who Makes Your Medical Decisions? How to Stay in Control with Palliative Care

Most emergency patients rely on physicians to tell them what to do. But if a patient says the following four words, the patient stays in charge:

“I receive palliative care.”

This compels physicians to listen to the patient first and order tests accordingly. Palliative care means “person-centered care.”

Dr. Kevin Haselhorst wants patients to guard against being put in the ICU by promoting home-based palliative care as the key to dying with dignity.  He has just published a new booklet, Is Palliative Care Right For YOU?, that provides a simple understanding of how best to handle complicated medical conditions.

Dr. Haselhorst teaches patients how to say “Thanks, but no thanks” to unnecessary medical intervention that will not improve their quality of life. Patients need to learn how to take their chances outside the hospital-based industry and advocate in their best interests.

Chronically-ill patients are never refused emergency treatment for fear of them dying. These patients are held hostage by the powers that be, i.e. physicians, nurses and family caregivers. Palliative care patients are given permission to refuse medical intervention out of respect for the person and the disease process. This level of understanding and compassion often escapes those geared to save lives.

While physicians are hesitant to suggest “less is more” and patients often feel more should be done for them, few people think of palliative care as being right for them until they end up in the intensive care unit against their will.

Dr. Haselhorst believes that it is critical for people to understand about what palliative care means in practical terms and the value and importance of making your own healthcare decisions.

He outlines a 10-point plan that defines what he believes are the most important patient goals and personal values:

  1. Natural death beats artificial life support.
  2. End-of-life conversations occur at the beginning of your chronic illness.
  3. Advance planning prevents unwanted surgeries and ICU admissions.
  4. Quality of life needs to be considered before unnecessary tests and procedures are ordered.
  5. Your best interest overrules physicians’ orders.
  6. Home-based palliative care reduces your having to stay in the hospital.
  7. Palliative care is considered a nursing practice, not a medical specialty.
  8. Your patient/caregiver advocate (nurse) lessens the need for a medical team.
  9. Spiritual well-being makes medical intervention unnecessary.
  10. Personal dignity overcomes the fear of death and dying.

By discussing the value of palliative care with emergency patients, Dr. Haselhorst views its immediate positive effect. Most chronically-ill patients are overjoyed with the prospect of returning home with more resources. Caregivers are thrilled to have a palliative nurse act as their advocate. It’s a win-win solution for difficult medical situations.

People in a variety of circumstances can benefit if they receive palliative care. These include, but are not limited to those who have been diagnosed with an incurable illness like cancer, those who can no longer live independently, and those who prefer to let nature take its course.

Palliative care allows patients to choose between “to live and let die” without any judgment for one being better than the other.

“The choice to remain at home and ultimately die in your own home is denied to patients who do not receive home-based palliative care”,” Dr. Haselhorst says, “… this is a personal and a financial decision that requires advance care planning. With palliative resources and a nurse advocate by your side, you have a say in how your remaining time and money are spent.”

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