Today is National Healthcare Decisions Day, a day dedicated to inspire and educate individuals and care providers about the importance of advance care planning. We are once again supporting this important initiative and hope individuals and care providers feel empowered and find inspiration in the resources available to them.
We strive to give everyone the tools they need to discuss, digitally document, and share future care preferences. And while it is our goal that every individual expresses their care preferences and ultimately has those preferences honored at end-of-life, we know we have a long way to go: 70% of people want to die at home, while only 30% actually do so.
Identifying your at-risk population and engaging them in advance care planning is critical to ensure proper care is delivered in the appropriate setting. Of individuals 65 and over in the U.S., 67% have multiple, chronic illnesses.This an important statistic as we know the elderly, chronically ill, and those with serious underlying medical conditions are at a high risk and are vulnerable to COVID-19. In fact, 78% of COVID-19 deaths are in patients 65 and over. How many of these individuals were seriously ill, died in a hospital, but would have preferred to die at home, in hospice care, or at a long-term care facility?
While we will never know the answer to this, we are committed to ensuring every individual receives the care they want at the end-of-life. As we navigate the realities of the pandemic, healthcare organizations have asked the same question. Frontline clinicians are demanding a better way to discuss, capture, and honor the care preferences for their at-risk patients. This information will help them.
What you can do to support National Healthcare Decisions Day efforts?
Perform an honest assessment of your advance care planning capabilities
Are ACP documents readily available to your providers, individuals, and loved ones? If you are the one regularly engaging in goals of care conversations, are the completed documents digitally accessible during an emergency? Unfortunately, we know only 31% of ACP documents can be found in an EHR. We have a collective obligation to actively discuss, capture, and honor care wishes and ultimately provide them across all care settings.
Engage your family members in advance care planning conversations
End-of-life conversations are difficult. No one is denying that. Have you, yourself, had these conversations with your loved ones? Reach out to a loved one to better understand if they understand what their options are at the end-of-life. Do they have an advance directive? A healthcare proxy? If they are at-risk, have a plan in place in the event they should become ill. In some surveys, less than 30% of respondents have advance directives, citing lack of awareness as the main reason for not having one. Starting with the momentum from National Healthcare Decisions Day, we can all work together to increase awareness and access.
Research resources available to both clinicians and individuals
We recently shared resources you can use to further efforts around advance care planning. These include tools, programs, and conversation guides from industry-leading experts like the Ariadne Labs Serious Illness Conversation Guide, Five Wishes, and VitalTalk. Many organizations are doing amazing things during this time.
As you reflect on your personal and professional experiences around advance care planning, ask yourself, is there a better way to do this? Do you regularly engage individuals in ACP consults? How is this being captured? During this time, are more people coming to you asking about ACP and can they complete ACP documents? Are these conversations now being had through telehealth? During these trying times, we’ve helped healthcare organizations pivot and adapt to virtual consults, so they can still engage in these conversations and collect appropriate signatures, electronically.
We hope on National Healthcare Decisions Day, clinicians and individuals feel empowered to demand a better way to document and honor end-of-life care preferences.