With National Health Care Decisions Day (NHDD) on April 16, Health and Senior Services Commissioner Mary E. O'Dowd is reminding New Jersey residents about the importance of advance care planning to document and communicate end-of-life wishes.
"Although discussing end-of-life issues may be difficult, having these conversations early and often before you are in the middle of a crisis will ensure your wishes are honored," said Commissioner O'Dowd. "Completing an advance directive and documenting your preferences is important no matter what stage of life you are in and if at any time your preferences change, you can easily update the document to what you want."
New Jersey has two kinds of advance directives, a "proxy directive" and an "instruction directive." A proxy directive, sometimes known as a durable power of attorney for health care, is a document that designates the person you want to make health care decisions for you in the event you become unable to make them yourself. An instruction directive, sometimes known as a living will, documents your values, beliefs and goals as they relate to your preferences for certain medical treatment.
Recently, Governor Christie signed legislation to create the Physician Orders for Life-Sustaining Treatment (POLST) ) form, an important step forward in helping residents and health care providers better manage end-of-life care. The law allows patients to outline the kind of medical care they want and makes it easier for providers to honor their wishes.
As a result of the new legislation, the Department of Health and Senior Services has appointed the New Jersey Hospital Association's (NJHA) Institute for Quality and Patient Safety, a federally designated Patient Safety Organization, to develop the POLST form and help plan its rollout to providers and consumers.
"NJHA is deeply committed to improving end-of-life care in our state, and we are honored to work with the Department of Health and Senior Services and clinicians statewide to enact POLST in New Jersey," said Betsy Ryan, president and CEO of NJHA. "We believe POLST can make a difference in ensuring that end-of-life care is driven, first and foremost, by the patient's goals and wishes."
Last month, Commissioner O'Dowd joined NJHA to kick-off the work of the committee that will develop the state's POLST form. The committee is comprised of physicians, attorneys and ethicists representing hospitals, post-acute care and emergency medical services. The NJHA will also promote awareness among health care professionals and the public about the option to complete a POLST form. Additionally, NJHA will provide ongoing training of health care professionals and emergency care providers about the use of the POLST form.
"The POLST form is an important tool for patients to determine with their health care provider what their goals are for the remainder of their days and what type of medical interventions they want taken to prolong their lives," added Commissioner O'Dowd.
The POLST form can complement an advanced directive, which can be used to designate the person you want to make health care decisions for you in the event you become unable to make them yourself and/or document your values, beliefs and goals as they relate to your preferences for certain medical treatment. The POLST form converts those wishes into a medical order available to health care providers.
"Ensuring that individuals have a say in their own end-of-life care is a critical resident's rights issue," said James W. McCracken, the state's Long-Term Care Ombudsman. "This can be a difficult conversation to have. But self-directed care is essential at every phase of life, and is especially important at end-of-life."
This month, McCracken and his staff have been providing information on advance care planning at pre-NHDD events across the state including presentations at the House of the Good Shepherd in Hackettstown; Seabrook Senior Living in Tinton Falls; and Friends Village in Woodstown. "During these events, we are screening an educational video, 'Anna's Story," about the importance of advance care planning and end of life discussions with friends and family," said McCracken. "We are using this video as a way of opening the conversation about these issues and providing guidance about advance directives, POLST, and other advance care planning tools."
On April 16, Office of Ombudsman of the Institutionalized Elderly (OOIE) staff will participate in NHDD events planned by the Tri-County Regional Ethics Committee at Brightview Greentree in Marlton and Pitman Manor in Pitman and will participate in an advance care planning event at Spring Oak Assisted Living in Vineland. These events will include legal advice, health screenings and palliative care education. In March, McCracken reached out to every licensed long-term care facility in the state urging them to provide advance care planning information in recognition of NHDD. Information for long-term facilities is available on the OOIE website at www.state.nj.us/ooie/nhdd/index.html
The Department of Health and Senior Services website provides forms, tools and guidance to help residents plan end-of-life decisions. The Department's online resources, available at www.nj.gov/health/advancedirective, include advance directive forms, educational materials, toolkits for completing an advance directive and links to websites with additional information on hospice and palliative care.
The Department of State also maintains a will registry to assist with advance planning. For more information please visit http://www.state.nj.us/state/dos_will_registry.html.
National Health Care Decisions Day is sponsored by many national, state and community organizations including the AARP, American Medical Association, American Bar Association and National Hospice and Palliative Care Organization.
