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Whatcom View: Advance directives share key end-of-life decisions

Whatcom View: Advance directives share key end-of-life decisions

By Dr. Bree Johnston

Courtesy to The Bellingham Herald


Join other Whatcom residents to participate in The RAMP UP to National Healthcare Decisions Day Event that will be held on March 16 at 5:30 p.m. in Settlemyer Hall at Bellingham Technical College. RAMP UP is intended as a kickoff to an ongoing effort to engage Whatcom County employers to motivate their employees to complete their advance directives as a key component in employees’ benefit package.

I feel passionate about this event because every day I see the comfort that family members have when their seriously ill loved ones have told them their end-of-life wishes — and the anguish when they don’t. I practice palliative care at PeaceHealth St. Joseph Medical Center. Palliative care helps people with serious illness determine what is most important to them, helps with tough decisions, and helps with symptom control and quality of life. Our team sees the incredible value of participating in advance care planning. And I’ve lived it. When my mother died at age 85, I was comforted to know that she felt she had lived a full life, did not want heroic measures taken, and was not afraid to die. This allowed my family to experience a pure uncomplicated grief after her death that was not clouded by guilt or doubt about whether we had made the right decisions. She had done her advance care planning well.

Advance care planning is an organized process of communication to help individuals understand and discuss goals for future healthcare decisions in accordance with their values. This process can result in a written plan – an advance directive – that represents the individual’s values and preferences, and helps prepare others to make healthcare decisions consistent with these preferences.

In LaCrosse, Wisconsin, which has had the most robust advance care planning initiative in the nation with Respecting Choices Advance Care Planning from Gunderson Health System, health care costs are among the lowest in the nation. In Lacrosse, patients are less likely to get aggressive end-of-life care that they don’t want because their providers and families are aware of their wishes. This is the opposite of health care rationing – this is aligning health care interventions with patient wishes. Patients don’t get care that they don’t want, they waste less money on unwanted care, and more health care resources can be spent for the benefit of all. Everyone wins from this process in LaCrosse.

RAMP UP is sponsored by Western Washington University’s Palliative Care Institute, in collaboration with the Whatcom Alliance for Health Advancement and The Northwest Washington Medical Society. The RAMP UP event is just one of many initiatives that is encouraging Whatcom residents to participate in advance care planning. For the past few years, Whatcom Alliance for Health Advancement has sponsored the End of Life Choices program, which helps individuals complete their advance directives and trains facilitators to extend the reach. In addition, the Washington State Medical Association and Washington State Hospital Association are sponsoring the project Honoring Choices Pacific Northwest, modeled after Respecting Choices. This initiative encourages health care systems to invest in advance care planning promotion and training; PeaceHealth is one of the early adopters of this program.

Whatcom County is proving to be a statewide leader in advance care planning, and RAMP UP will bring us one step closer to being an innovator in this area. Bringing about an improved health care system requires awareness and persistence on the part of the community, and advance care planning is one important element in that process.

Join us at Settlemyer Hall at Bellingham Technical College on March 16 at 5:30 p.m. for RAMP UP. Admission is free and no reservations are required. Keynote speakers will be Dr. Meg Jacobson, director of Whatcom Hospice and a long time champion of advance care planning in our community, and Dr. Scott Foster, a leader of the PeaceHealth Medical Group. There will also be light refreshments, music and door prizes.

For more information about the Ramp Up Event, go to wce.wwu.edu/bsn/palliative-care-institute.

Dr. Bree Johnston is immediate past president of Northwest Washington Medical Society and head of Palliative Care for PeaceHealth.