Healthcare providers, including case managers, can bring up end-of-life issues with their most frail and ill patients by approaching it in a Q&A format.
For instance, Mary Mareck, MSW, a geriatric consultant and founder of Mareck Family & Geriatric Services in Lansing, MI, developed the following list of questions that can lead into a discussion of advance directives:
- What is my diagnosis, and how does it relate to other medical conditions I have?
- What are the treatment recommendations?
- What are the side effects, long- and short-term?
- Where, when, and how will the treatment take place?
- Will treatment lead to a longer or more comfortable life?
- What are the risks and benefits of the treatment? If it is not successful, what will be the next step?
- Does the cost justify the outcome?
- What if I change my mind because the side effects do not support the benefits of the treatment?
- If we want more information before making a decision, where can we get it? Second opinion?
- If I do not want the treatment, what will happen, how much time will I have, and what will that time be like?
- If my goal is to die peacefully — not in a hospital, but with my family — where does this treatment fit? Does it match my goals?
- Is hospice something to consider at this time?