There’s a new term being used by Medicare for end-of-life counseling and that’s “advance care planning.” When diagnosed with a terminal illness or life threatening disease like Stage II, Stage III, Stage IV cancer, congestive heart failure, COPD, ALS, MLS and other serious health conditions, it’s important that everyone around you understands and knows what your wishes are about your end-of-life care at different stages of your illness. That’s where advance care planning is key.
Advance care planning is making decisions about the care you would want to receive if you happen to become unable to speak for yourself. These are your decisions to make, regardless of what you choose for your care, and the decisions are based on your personal values, preferences, and discussions with your loved ones. If you are in an accident or have a serious terminal illness that leaves you unable to talk about your wishes, who will speak for you? You can tell your family, friends and healthcare providers what your wishes and personal beliefs are about continuing or withdrawing medical treatments at the end of life.
Decisions about end-of-life care are deeply personal, and are based on your values and beliefs. Because it is impossible to foresee every type of circumstance or illness, it is essential to think in general about what is important to you. Conversations that focus on your wishes and beliefs will relieve loved ones and healthcare providers of the need to guess what you would want.
While Medicare is planning to pay for these voluntary end-of-life discussions, it’s important to do similar planning for your financial situation. If you are diagnosed with a terminal illness or life threatening disease like Stage II, Stage III, Stage IV cancer, congestive heart failure, COPD, ALS, MLS and other serious health conditions, how are you and your family going to cover all of these unexpected costs? In some situations, cancer treatments can cost anywhere from $10,000 to $30,000 a month. If you’re in need of palliative care, some of these costs may not be covered by Medicare, Medicaid or private insurance. Often times, individuals with a life insurance policy will sell their life insurance policy (through a viatical sale/settlement) or take out a life insurance loan. These are important questions and options to consider when engaging in advance care planning.
End-of-life counseling by doctors aims to discern the type of treatment patients want in their last days, with options ranging from care that’s more focused on comfort than extending life to all-out medical efforts to resuscitate a dying patient. With this new regulation, Medicare will pay for doctors to have end-of-life conversations, and this will be completely voluntary for patients.
“As a practicing physician, and a son, and someone who has dealt with this in his own family, I would say these are discussions … that are critical to high-quality care,” said Patrick Conway, Medicare’s chief medical officer. “I would want any American who wanted to have this conversation with their clinician to have the opportunity to do so.”
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