“It’s never too early, who will be your voice?”
Last week, we celebrated National Healthcare Decisions Day (NHDD), which exists to inspire, educate, and empower the community and providers about the importance of advance care planning (ACP). Advance care planning is the process of exploring your healthcare wishes, sharing preferences with family and designated healthcare agents, and completing legal documents to prepare for the end of life.
We cannot predict the future, but we can put plans in place to ensure that our healthcare wishes are articulated and shared with the people who can make decisions that reflect our values. It is a little like planning for retirement. While no one knows what the financial markets will look like in 20 years, you know what you have now, what you want your life to look like and what you need to get there, and your risk tolerance. You do your research and make the most informed decisions possible knowing you can make changes at any time as needed.
Dr. Kelley Elwell, DNP, APRN, FNP-BC, joined Central Vermont Home Health & Hospice earlier this year as Hospice & Palliative Care Nurse Practitioner bringing over a decade of experience as an oncology and radiation therapy registered nurse in Florida and a hospitalist in Vermont for the last 5 years. Dr. Elwell thinks everyone 18 years and older should, at minimum, have a health care agent. She believes advance care planning is essential if you have been diagnosed with a life-limiting illness such as cancer, heart, lung, or kidney disease, and Alzheimer’s or dementia. “It is important to explore your values so your wishes can be followed. Wishes can change overtime as your overall health status changes, especially if you have a life-limiting or terminal illness. It is never too early, who will be your voice?”
Since joining CVHHH, Dr. Elwell has been busy meeting with Central Vermonters and with CVHHH’s provider partners at UVMHN-Central Vermont Medical Center, local practices, and in the community, to spread her message about the importance of advance care planning and how to take the first step. Dr. Elwell acknowledges that for some people, advance care planning is not an easy process and often happens over time and in steps. Dr. Elwell is here to help. If you are thinking about starting the advance-care planning process, here are important considerations.
Understand the care options available to you. If you are living with a life-limiting illness, you have two options: palliative care and hospice care. “Chronic illness takes so much independence from patients and their families. Palliative and hospice programs are effective in providing education, pain and symptom management, and holistic support to meet patients’ and families’ needs, and they can give back some control over what a person would like the end of their life to look like.”
Dr. Elwell advises people to think about their preferences and what she calls the hard N-Os, which are the things you would not be willing to endure even if those things could potentially lengthen your life. Questions to ask include: What matters most to me in a healthcare context? Where do I prefer to die (in a hospital, at home, in a facility)? Who do I trust to honor my healthcare wishes and speak on my behalf?
Dr. Elwell spends a significant amount of time educating people on what certain interventions, such as CPR and intubation, look like in real life. “It is not what we see in the movies. I advise people to understand how these things can impact their quality of life, even if it temporarily extends the length of their life. Do what you can to research and identify the interventions that are unacceptable to you and what means the most to you. As a health care community, we need to normalize ACP discussions in younger populations. No one is promised tomorrow, and by offering time and space to explore an individuals’ wishes, we will create a culture of preparedness for the end of life.”
Dr. Elwell is available for in-person or phone consultations to discuss your condition and goals of care and to answer questions about how CVHHH can support you to have the best-possible quality of life and maintain your independence. Call 802-223-1878 and ask to speak to Dr. Elwell.