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Begin the conversation before it's too late

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By Rachel Johnson, Staff Writer

 SUPPLY—The statistics are overwhelming—one in one person will die.

The reality of death isn’t one most Americans want to face, but it is a reality everyone must confront at some point.

The Lower Cape Fear Hospice & LifeCareCenter wants to help get the conversation started.

“Its something most of us really don’t want to deal with and talk about,” said Jason Clamme, director of community outreach. “But end of life is going to be a part of every life.”

The message is to encourage people to identify and communicate their health care choices. The question often arises of why should I talk about that now; I don’t plan on dying anytime soon.

“It is not something that applies at a certain age. It applies at any time,” Clamme said.

The reality is that at any time people can become unable to communicate their health care choices as a result of a serious injury or illness. When this happens, loved ones are put into a tough position of speculation and second-guessing. It can cause family disputes and can leave decision-makers with feelings of guilt questioning if they made the right choice. But if the conversation has already begun, when the time comes, the desires of the individual are already known.

“I know first-hand it is not an easy conversation to bring up,” Clamme said. “I didn’t want my parents thinking I was thinking about them dying.”

Clamme cites the Terri Schiavo case as a prime example of the importance of starting the conversation.  Her situation brought the right to die battle to the forefront of national attention. Her husband fought for her right to die and her parents fought for her right to live.

“The one person who knew what was best for Terri was Terri and she couldn’t speak,” Clamme said. “After that so many people came to me and wanted to know what they could do to make sure that didn’t happen to them. It is all about making these decisions for yourself so other people don’t have to.”

The first step involves two basic forms: a living will and healthcare power of attorney.

“You don’t have to have a living will. Advance healthcare planning is as much talking about what you don’t want as it is about what you want,” Clamme said.

It is suggested that if you do sign a living will that you know, understand and discuss what it says.

“If I ever become terminal and incurable and I cannot communicate, it is OK to discontinue extraordinary means,” Clamme said. “A living will gives us all something to base a decision on, but ‘terminal and incurable’ how do we know that? These are guesses made by human beings. It is a pretty gray area. And extraordinary means, what is that?”

The answers, Clamme said, differ for each person and each circumstance. The living will can have some questions about where it applies to a particular situation.

The second part is appointing a healthcare power of attorney. This is the person who is in charge of your healthcare when you can’t be. The majority of people select a family member. In a case where a healthcare power of attorney has not been appointed the state relies on a person’s next of kin to step in. First in line is the spouse. Next it falls to the children or a living parent before moving on to siblings.

“Sometimes a family member is too close to make that decision; it can be too difficult for loved ones,” Clamme said. “You must pick a person you trust who is willing to do it.”

Begin the Conversation recommends not only selecting a healthcare power of attorney but also sharing with this person where your important documents are and even passwords to online accounts.

Working in hospice care, Clamme and other employees and volunteers have seen the difficulties encountered when a patient’s wishes are unknown by the family. He stresses the importance of not only making a plan but in communicating one’s wishes with family and loved ones.

“If the family hasn’t heard it and it comes as a surprise it can tear the family apart and put the healthcare power of attorney in a difficult position torn between your wishes and the family,” Clamme said. “The conversation has to be inclusive. It is not an easy thing to do to start the conversation. The first thing to do is to plan yours, give it to the person and say, ‘What about you?’”

Lower Cape Fear Hospice has a variety of resources available to help people get started both online and in print form. Visit www.BegintheConversation.org for more information. Additional forms available to help with advance healthcare planning are MOST and DNR forms. These are filled out by a physician and must be discussed with them. If you are interested, ask your doctor about the forms.

The Lower Cape Fear Hospice is dedicated to reaching as many people as possible with the message of planning for the future before it’s too late.

As a part of the organization’s public education initiative, end of life planning is available to the entire community. To set up a time to talk about end of life planning with your group or organization contact Rebecca Long, community outreach coordinator, at 796-7928, Rebecca.Long@lcfh.org or online at www.hospiceandlifecarecenter.org. For more information on the Begin the Conversation program, visit www.BegintheConversation.org.