Asking about advance directives? A routine question at Columbia Medical Practice

At Columbia Medical Practice, every Medicare patient’s annual wellness exam includes questions about diet, physical activity, general health concerns – and whether the patient has an advance directive. The question, and the offering of educational resources on the topic, have become the norm at the practice since it began partnering with the Horizon Foundation on the Speak(easy) Howard campaign.

“This is an important part of your medical needs,” said Karen Allen, a registered nurse at Columbia Medical Practice.

For patients who already have their health care wishes documented in an advance directive, Columbia Medical Practice ensures that it is on file for doctors and staff in case of an emergency. Since the practice started bringing up the topic in appointments, the number of patients who have brought an advance directive for their file has jumped from 18 percent to nearly 50 percent.

For those who have not completed an advance directive, the routine annual question helps encourage patients to start the process of considering and documenting their wishes and discussing them with loved ones.

“Some people don’t want to talk about it, but if we see them regularly and encourage them little by little, we can make a difference,” Allen said. “When you make your own decisions ahead of time about what kind of care you want at the end of your life, you are doing a huge favor for your family and loved ones.”

Allen knows this firsthand, not only from her experience in health care but also with her own family. When her father suddenly suffered a heart attack, he was 79 years old and healthy. Emergency medical professionals quickly performed CPR but after nearly half an hour, efforts were unsuccessful. As she discussed the situation with her mother who was with her father in another state, they paused to consider: “What did he want?”

Both knew his health care wishes because of extensive family conversations about planning for future critical care in the event of an emergency. “We all knew what his wishes were, and we were all on the same page,” Allen said. “We were able to work together to make sure his wishes were honored, and to say, ‘It’s okay if I tell them to stop.’”

Based on her medical knowledge, Allen knew that continued CPR attempts as time passed would increase the chances of serious effects on his brain, physical abilities and quality of life. Allen says she, her mother and siblings knew “he didn’t want this.” With the grief and sadness of her father’s death, Allen is grateful that the family had the peace of knowing his wishes far before his heart attack.

“Not having a conversation is really hard, but I know what he wanted,” Allen said.

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