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Advanced directives shift focus from illness to patient goals

Amid the clamor generated by daily information resources folks in New Jersey may have missed the fact that April 16 was National Healthcare Decisions Day. It was the fifth annual. Its intent, according to the NHDD website, is to "inspire, educate and empower the public" about the importance of advanced directives regarding personal care. We can identify with that.

The concept in that list that perhaps stands out is that of empowerment. The reality of our current health care system is that it is rooted in a norm that usually involves going to a doctor when you're sick, the doctor telling you what to do and you doing what the doctor orders; maybe. Patient empowerment, that is, ensuring that patients are as informed as they can be to make the best decisions about their care, is usually not part of the picture.

This can be a particular issue in cases where a patient suffers from chronic illness or is dealing with an end-of-life condition. Patient empowerment employed in such cases involves patient engagement and tends to shift the focus of care toward achieving the patient's goals, rather than those of the care provider.

What engagement and empowerment does is allows patients to express their wishes. It also gives doctors and care facilities guidance on how to respect whatever those wishes might be. Research suggests that such empowerment makes for better outcomes.

Living wills, or advanced directives, are estate planning tools that can help spell out those wishes. But some legal experts suggest they are not enough. In addition to having a properly drafted living will, individuals should also appoint a health care proxy. This would be someone who would be fully aware of your needs and desires and who will be able to advocate for you when you can't.

Do you still have questions? You can contact an attorney to get some answers. If that's too much of a step, at least begin to engage loved ones in the discussion. To help get that started try visiting the Engage with Grace website. There you will find a simple five-question form that can begin to help frame a possible discussion.

Source: Forbes, "Can Patients Make Good Decisions?," Carolyn McClanahan, April 16, 2012

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