Who benefits if Americans are afraid to talk about death and dying? Or even making choices about the quality of their own end of life care? Clearly not the taxpayers, who according to a study by Duke University, save $2,309 for each Medicare patient who chooses to die in a hospice. Clearly not the family and friends who love the patient. Another study showed that patients in hospice live 29 days longer. Certainly not patients with a life-limiting illness, who can live at home with hospice care with less pain, fewer symptoms, and more dignity. Being able to talk about death, to plan and share advanced directives, benefits our country, our family, and the person who is dying.
So who benefits if people can’t talk about death and dying? The people who profit from the status quo, where 80% of health dollars are spent in the last two months of care, such as giant health care systems and huge pharmaceutical firms. The callous people who are paid to fight for these companies are preying on the fears of seniors to stop any movement toward a more patient-friendly health care system. Conservative politicians like Sen. Chuck Grassley (R-Iowa) are stooping to lies like the government will “pull the plug on Grandma” to rile up the most gullible members of his base.
As the Iowa Independent wrote, “The proposal to which Grassley referred would merely require Medicare to pay for end-of-life counseling sessions for anyone who would like it. It would also be completely voluntary. In Iowa, a similar law is already on the books, and Grassley’s grandson, state Rep. Pat Grassley (R-New Hartford), voted for it in 2008.”
Fortunately the people involved in the hospice movement know enough to push back. For example, the leaders of the Lucas County End of Life Coalition in southern Iowa wanted their neighbors to prepare their advanced directives to help themselves and their families. In a big county with only 9,400 people, it is impossible to go door to door, so they go to an event where most people already are: the Fourth of July parade around the courthouse square. They made a float by putting their own living room furniture on a farmer’s hay truck. Then they made a big sign that said, “Isn’t it time we should talk?” and their volunteers acted like a family discussing what the grandparents wanted.
This is how America should be talking about end of life care: in our own living rooms, at our own kitchen tables, and with our own doctors. Not being terrorized by conservative politicians exploiting the fears of the uninformed.
More and more churches, synagogues, companies, and unions are urging their members to prepare their own advanced directives, using tools such as the Five Wishes. Ask your own doctor sooner rather than later. As Dr. Diane E. Meier wrote in Des Moines Register these conversations “are quality-of-life conversations that should occur early in the doctor-patient relationship. If you want to learn more about hospice care and find hospices in your own area go to the National Hospice and Palliative Care Organization, also Information en Español .
As the debate on national health care continues, use this opportunity to sit down with your own family and friends to say, “Isn’t it time we should talk about our plans for end of life?” Regardless of how many bullies want to shout down politicians, you can still make a difference by making it a time to talk, softly and patiently, to the people you love about how they want to live until they die. About the choices they are free to make. And about what would make them happy. Life, liberty, and pursuit of happiness – what could be more American than that?
Joan Flanagan is the Fundraiser for the Center for New Community. In 1978, she was one of the nine founding members of Horizon Hospice, the first hospice in Illinois. After 11 years on the Horizon Board of Directors, she has served 25 years on their Advisory Board. She reminds her own family and friends to prepare their advanced directives.