Thursday June 11, 2015

By Donna L. Wagner, Ph.D.
Interim Dean, College of Health and Social Services, New Mexico State University

Talking about death and end of life issues is probably the last thing most people are interested in doing. Many believe that it’s sad, morbid and unpleasant. Perhaps that’s why we have developed so many euphemisms for death: “He passed,” “She is no longer with us,” “he ate the banana,” “kicked the bucket” or “crossed over.” No matter what your preferred term may be, it is likely seen as more palatable and acceptable than using the “d” word.

At the recent health symposium on the topic of death convened by the College of Health and Social Services at New Mexico State University, Gail Rubin, who organized the death café during our lunch, reminded the audience of this important fact: “Talking about sex won’t make you pregnant and talking about death won’t make you dead.”

The conference was organized to give the community of Las Cruces, New Mexico, both residents and health professionals the opportunity to spend the day talking about the very personal topic of death; more than 400 people showed up.

“A Beautiful Death: What will you choose?” opened with a presentation by Peggy Battin, a bioethicist from the University of Utah who has been studying end of life issues her entire professional career. She challenged the audience with important ethical dilemmas that are timely today as the circumstances around the end of life have changed and are changing due to health technology and medical advancements that can keep us alive. These changes raise the bar for us all as we watch our parents and grandparents face a complicated set of decisions that no one had to make in the past.

Around the nation, end of life issues are being discussed. In part this is a function of an aging population and increasingly large health expenditures for care at the end of life.

Palliative care is not available in all communities and many health professionals are not clear of the value of palliative or what is the scope of the care and what should not be included. Absent a more rationale and informed approach to the end of life on the part of patients and health professionals, the end of life will continue to be an expensive proposition for our health care system. And, more importantly, unnecessary pain and suffering for the dying and their loved ones.

In a 2013 issue of the American Journal of Public Health “End-of-Life Care Issues: A Personal, Economic, Public Policy and Public Health Crisis” describes the lack of advance care plans in place for most Americans. The authors point out the irony that while the majority of Americans want their wishes to be respected at the end of their lives, only about one-third say they have completed paperwork like the Five Wishes or other advance care planning documents.

Who would you want making decisions about your care when you are dying and unable to speak for yourself? If you haven’t been talking about your wishes, either with your family or preferably through a written document that can be shared with your physician and at the hospital where many die today, the decision-maker will likely be someone who doesn’t know you or if they do, doesn’t know what you want.

Every state in the nation has an advanced care form online for you to use to memorialize your wishes. It’s important to get all the information you need to make an informed decision that is right for you. This is best managed by talking to those you love and others who know something about end of life situations. If you still have trouble talking about death, just fill out the form online and hand a copy to a trusted family member. It is the most important gift you can give them. Read more about the symposium here.