Christie Administration Recognizes National Healthcare Decisions Day April 16
In recognition of April 16 as National Healthcare Decisions Day, the New Jersey Department of Health is encouraging Garden State residents to discuss their healthcare preferences and plan ahead for end-of-life care decisions with their physicians and family. National Healthcare Decisions Day highlights the importance of documenting your health care preferences.
"The best way to ensure that your dignity and autonomy are honored should you become unable to make your own health care decisions is by sharing your wishes about end of life medical treatment," said New Jersey Health Commissioner Mary E. O'Dowd. "By reviewing options for care and having discussions in advance, individuals can alleviate some of the challenges that come along with a serious illness."
Individuals should consider what type of care and treatment they would prefer near the end-of-life. For example, as part of planning they may want to review palliative care and hospice programs. Palliative care focuses on improving life and providing comfort to people of all ages with serious, chronic, and life-threatening illnesses. Hospice programs provide medical services, emotional support and spiritual resources for those with terminal illness. Hospice also offers support to family members as they face the challenge of caring for a loved one with a terminal illness. Individuals may also want to consider specific medical interventions they would like to have when they are near the end of life. Some people would prefer to have every medical treatment taken to prolong their life, while others may not want to have their life sustained with medical support such as the use of a ventilator or feeding tube.
In 2011, Governor Chris Christie signed New Jersey's Practitioners Orders for Life-Sustaining Treatment (POLST) law, which allows patients with a life-limiting illness, in collaboration with their health care provider, to identify goals of care and preferences for treatment. The Department worked closely with the New Jersey Hospital Association (NJHA) Institute for Quality and Patient Safety on the development of a form and guidance to implement the law. Since then the Department and NJHA have developed and released the POLST form, Guidance for N.J. Healthcare Professionals and materials for patients and providers in several languages, all of which is available at http://www.njha.com/quality-patient-safety/advanced-care-planning/polst/. Recognizing that many residents travel to nearby states for employment, recreation and for health care, the Department has also shared information on POLST with neighboring states to assure recognition of and compliance with New Jersey's POLST law.
"New Jersey's POLST form is designed to be completed jointly by an individual and a physician or advance practice nurse. It truly is a partnership between the patient and the healthcare professional" said Elizabeth A. Ryan, Esq., NJHA President and CEO. "We're working with healthcare providers, through Webinars and other training programs, to emphasize the importance of POLST and its great potential to improve the end-of-life care experience."
A POLST form provides instructions for health care personnel to follow for a range of life-sustaining treatments such as feeding tubes, ventilators and medication. The POLST form is designed to document end-of-life care preferences of those who have a terminal illness or a compromised medical condition.
While POLST is focused on residents who are facing a life-limiting illness, Advance Directives can be used by individuals in any stage of life. Advance Directives are an important tool to document preferences for care in a situation where an individual can no longer communicate.
In New Jersey, there are two kinds of advance planning documents that allow individuals to document end-of- life care preferences. A "proxy directive" and an "instruction directive" are both legal documents that residents can complete on their own. They only go into effect if a physician has evaluated the patient and determined that the patient is unable to understand the diagnosis, treatment options or the possible benefits and harms of the treatment options.
A proxy directive, which is sometimes known as a durable power of attorney for health care, allows individuals to designate a "health care representative" to make health care decisions on their behalf should they become unable to make their own. An instruction directive, sometimes known as a living will, is a document that records an individual's values, beliefs and goals as they relate to preferences for certain medical treatments.
"It is important to have conversations with your loved ones and your doctors about the care and treatment you want to have in case you are unable to speak for yourself. It is the ultimate act of empowerment, to make sure that you are cared for and treated in a manner consistent with your wishes should you become seriously incapacitated or nearing the end of your life - or both," said James W. McCracken, the state's Long Term Care Ombudsman.
The National Institutes of Health has a web page dedicated to helping individual prepare for the end of life, which includes types of care available and questions that individuals should consider when planning. This web site can be found at: http://nihseniorhealth.gov/endoflife/preparingfortheendoflife/01.html
Please visit www.nhdd.org for more information on National Healthcare Decisions Day.