By PATRICIA A. BOMBA, MD, FACP
Professionally and personally, I support the decision by CMS to reimburse for advance care planning conversations. Doctors should help initiate discussions with their patients about such decisions. This is an important step to ensure individuals receive the treatments they wish to receive and those they wish to avoid.
Equally important to having a discussion with your physician and other clinicians is to have a conversation with your family. Advance care planning should begin early. Choose the person you trust to make medical decisions if you lose the ability to make medical decisions and share your personal values, beliefs and what matters most with your family and “family by choice.”
Advance care planning is a gift to yourself and your family. What better time to start a conversation than at Thanksgiving when your family gathers for the holidays.
In our family, we have a Thanksgiving tradition dating back to 1992 that has nothing to do with food or football, but rather personal beliefs, values and expectations. It’s our annual family discussion of issues related to Advance Care Planning. I encourage every family to embrace this Thanksgiving tradition. These Thanksgiving discussions helped my family and I honor my mom’s wishes at the end of life.
Years ago my family started this tradition on Thanksgiving because it’s an American holiday that just about everyone celebrates, attracting family members from far and wide. While at first you might think it’s morbid to discuss such issues at a festive gathering, we’ve found sharing our wishes for end-of-life care actually brings us closer. We each gain peace of mind knowing our own wishes will be understood and honored in the event we can’t speak for ourselves. In our family,
"No pumpkin pie, until you tell me how you want to live until you die."
After the dinner dishes are cleared, the adults in our family stay at the table and talk about what matters most in our lives. We review our advance directives to make sure they reflect our current feelings. We have blank forms handy in case new documents need to be completed and witnessed.
As a medical doctor and health plan administrator with an expertise in palliative care and end-of-life issues, I’m especially passionate about Advance Care Planning. I recommend that everyone 18 and older complete advance directives and keep them on file with their physician, their lawyer and most importantly, their loved ones.
Please share my family's Thanksgiving tradition!