Medical students.

Buffalo Mayor Byron Brown joins Jacobs School of Medicine and Biomedical Sciences medical students in promoting National Healthcare Decisions Day.

Urging Discussions About End-of-Life Care Wishes

Published May 8, 2019

The idea behind National Healthcare Decisions Day (NHDD) acknowledges that some of life’s most important discussions are the hardest to undertake.

NHDD, held this year on April 16, exists to inspire, educate and empower the public and health care providers about the importance of advance care planning.

To that end, several groups, including medical students from the Jacobs School of Medicine and Biomedical Sciences, manned information tables on the subject at all three UB campuses, Daemen College, Erie County Medical Center (ECMC) and Buffalo City Hall.

Questionnaire Acts as Icebreaker on Topic

The organizers of the local arm of the national event were Kathleen T. Grimm, MD, clinical assistant professor of medicine in the Division of Geriatrics and Palliative Medicine and director of ECMC’s palliative care; Juli Chikaraishi, project manager for The Conversation Project at ECMC; and Sandra Lauer, ECMC’s director of continuum of care.

The Conversation Project is a national initiative of the Institute for Healthcare Improvement dedicated to helping people talk about their wishes for end-of-life care. Its cornerstone is the Conversation Starter Kit, which contains a list of thought-provoking questions.

“It is a questionnaire that asks about personal values instead of using a lot of technical medical jargon, which is what most of these types of forms are like,” says Tim Felong, a second-year medical student.

Table with materials.

Materials geared toward helping families start discussing important issues, such as wishes for end-of-life care, were handed out during the event.

Important, But Uncomfortable Conversations

Another important component is a health care proxy, a legal document that allows an individual to appoint someone they trust — for example, a family member or close friend — to make health care decisions for them if they lose the ability to make decisions themselves.

Felong points out a telling statistic from a national survey The Conversation Project conducted in 2018, which is that 92 percent of people say talking with their loved ones about end-of-life care is important, but only 32 percent have actually done so.

“There is a huge discrepancy,” he says. ”These can be uncomfortable conversations, but they are important ones.”

Conflicts Can Arise When Families Under Stress

Felong said difficult circumstances could occur if these types of conversations are put off.

“If somebody finds themselves in a situation where they are unable to speak for themselves, then the people that have to make those decisions are usually family members,” he says. “A lot of times there are disagreements, arguments and conflicts.”

“It’s also not a great situation for health care providers because they may be uncertain about how to proceed if you have not signed the forms or had any of these conversations,” Felong adds.