Family physicians can play active role in end-of-life decisions
The campaign strives to spotlight the role family and primary care physicians can play in end-of-life care. In addition, it has made materials about subjects like providing comfort and advance directives for physicians to give their patients and caregivers.
Materials on advance directives contain detailed information about setting up living wills and "do not resuscitate" orders.
A vocal advocate on hospice matters, Dr. Jayette Orgain, spokesperson for the American Academy of Family Physicians (AAFP), said family physicians should be an integral part of the end-of-life care process for their patients.
"We cannot tell patients when the end of life will come, but we can recommend the point at which certain treatments will no longer enhance their quality of life," Orgain said. "For example, if you are feeding someone who cannot absorb nutritional supplements and they are at risk of developing pneumonia from aspiration, what should you do next? It is a difficult decision to withdraw life support.”
Orgain said caregivers of patients nearing the end of life -- who may be elderly and have medical concerns of their own -- also need spiritual, emotional and physical support.
“Because of the intensity of the care required and related stress, caregivers can suffer with their own health problems,” she said.
Dr. Thomas Cornwell practices at HomeCare Physicians in Wheaton, Illinois. He said that while a recent study showed a great number of Americans said they would want to die at home if given a choice, most of those people would probably spend their last days in a medical facility or nursing home because they neglected to make their final wishes known and put them in writing.
Cornwell said that, when making decisions about end-of-life care, patients need to decide how aggressive they want their care to be. He recommended using the Physician Orders for Life-Sustaining Treatment (POLST) form at www.polst.org. Another resource is the Five Wishes form at www.agingwithdignity.org.
"It's a very easy, user-friendly form for patients to have as a power of attorney for health care that asks questions and takes you through different scenarios to let your loved ones know what your wishes are," he said.
Cornwell is also an advocate of pre-planned funerals.
"This is another way to try to make the end of life easier," he said. "It's going to be sorrowful, but it doesn’t need to be a crisis if we prepare for it like we prepare for everything else."
Organizations in this story
American Academy of Family Physicians 11400 Tomahawk Creek Pkwy Leawood, KS 66211