By Dr. Alvin H. Moss and Courtney Dunithan, MSW, LGSW
For the past decade, National Healthcare Decisions Day has highlighted a time when people can pause and focus on what treatment they want near the end of life. In 2017, that valuable event is being expanded to include an entire week, April 16-22, to encourage people to talk to their family, friends and healthcare providers about this important issue.
The West Virginia Center for End-of-Life Care, which receives funding from the state Department of Health and Human Resources, is pleased to again serve as the state liaison for this national effort.
In stark contrast to the many metrics where West Virginians rank near the bottom of national healthcare statistics, we actually are among the leaders when it comes to filling out advance directives. The e-Directive Registry, a secure database maintained by the West Virginia Center for End-of-Life Care, allows medical professionals from emergency medical technicians to hospital physicians to quickly access patients’ preferences, allowing people to receive exactly the level of care they want.
Organizations across the state will be coordinating events as part of National Healthcare Decisions Week, and you can find one near you by visiting our website, www.wvendoflife.org, or by calling 1-877-209-8086.
Most people who have been informed about its benefits want to complete a living will that indicates what care they do – or do not – want when they are dying and unable to communicate for themselves. Likewise, it is really a good idea to complete a medical power of attorney to specify who should make decisions for you when you are unable to make them for yourself.
Depending on your personal condition, you and your physician may also want to consider a “Do Not Resuscitate” card that indicates you are not to receive CPR if your heart stops or if you stop breathing.
The West Virginia system also includes the option for seriously ill patients of completing a POST form (Physician Orders for Scope of Treatment) that converts your wishes into medical orders that are honored throughout all health care settings. Research done in West Virginia shows that a person’s medical treatment wishes are most likely to be respected if they are recorded on a POST form.
By submitting your form, you will become part of a growing number of West Virginians who have ensured their wishes will be respected near the end of life. In 2016, the Center distributed more than 80,000 advance directive and medical order forms, and since 2010, more than 65,000 forms have been filed with the e-Directive Registry.
Research shows that most West Virginians want to die at home, rather than in a hospital or other facility, and data show that for 2016, nearly half of people who participated in the Registry died at home, compared to 36 percent of all deaths in the state. For those who participated in the Registry the percentage of individuals dying in the hospital was half that of those who did not, and the hospital is the most expensive place to die.
The average cost per patient per day in a hospital stepdown unit is $7,857, while the cost per day of home hospice care is just $180. For all locations in the hospital including the ICU, the average cost for the final six days of life is $10,940 lower for a Registry participant, a savings of $1,633 per day. With 4,139 Registry participant deaths in 2016, that means a savings of more than $45 million on health care charges at the end of life for West Virginians with forms in the Registry.
The process of dying is never easy, for patients or their loved ones. By ensuring your wishes are clear and identifying someone to speak for you if you are unable to communicate for yourself, you make at least one aspect easier for both you and your family.
To find out more about National Healthcare Decisions Week events in your local community, visit the West Virginia Center for End-of-Life Care’s website www.wvendoflife.org or call 877-209-8086. The center also provides free information and tools (including free advance directives forms) to help West Virginians to put their wishes in writing so that they will be followed.
Dr. Alvin H. Moss is Director and Ms. Dunithan the Associate Director of the West Virginia Center for End-of-Life Care, which is based in Morgantown but works statewide.
