Consider Advanced Planning At Your Next Medicare Appointment
Written by: Faith Jones, Director of Care Coordination at Healthtech
The opinions expressed in this column of those of the writer and do not necessarily reflect AARP policy.
As the holidays approach, many begin to think about what kind of gift they should get for family members; and we start being asked by family members what we want for the holidays. One of the most precious gifts we can give and receive is an open and honest discussion about our health care decisions.
Specifically, this means putting together an advanced care plan with your healthcare providers. This is a conversation providers are willing to have, and want to have with you and your family. Medicare covers these advance care planning appointments when the conversation occurs in conjunction with your annual wellness visit. There are no out of-pocket costs to Medicare beneficiaries. These conversations are a part of your wellness plan. Considering end-of-life care decision making as a wellness service highlights the fact that everyone should have these conversations well before there is a serious diagnosis or a serious injury occurs.
If you are not sure about how to begin thinking about or starting this conversation, the Institute for Healthcare Improvement (IHI) has developed some questions to consider.
The questions are easy to answer, and cover things like: what does a good day look like for you; or what matters to me through the end of my life is… Other questions include how much you want to know about your treatment, if you feel you need to have a say in every healthcare decision, or if you worry you will get too much or too little care at the end of your life. The IHI discussion guide ultimately helps you get to the bigger questions, such as whether you want to try every treatment to extend your life (even if it is uncomfortable) and even where you want to spend your final days - at home or in on-site medical care?
After considering some of these questions, make your annual wellness appointment and be sure to let them know that you would like your appointment to include an advance care planning conversation to ensure you are scheduled for enough time. You can request your annual wellness visit and advance care planning appointment as a telehealth appointment and they can be performed from the comfort of your own home.
As a nurse, I have had the honor and privilege to care for patients at the end of their lives. Caring for patients during this time also includes caring for the families of the patients. Although the end of life is always filled with some sadness, it can be accompanied by either peacefulness or angst. In my experience, the difference between families having feelings of peace or anxiety is dependent on the level of understanding of their loved one’s wishes. In those situations where there have been frequent conversations to gain a full understanding of their loved one’s health care decisions, families tend to be more at peace with end-of-life care.
However, when these conversations have not taken place and families are unsure of the type of care their loved one wants to receive there is a lot more anxiety, guilt, fear, and second guessing of each other in a time when families need to be supporting each other instead of being at odds with care decisions. If you are unsure what matters most to your loved ones as related to their health care choices, ask for the conversation as your gift from them.
Faith Jones is the Director of Care Coordination at HealthTech. She is certified in advance care planning
