One patient was being help alive on a ventilator after being declared brain dead. McDonald asked the patient's family if they had ever discussed end-of-life issues with her, such as how long to continue such medical interventions when there is little hope of recovery.
“They looked at each other like, ‘Heavens no!'” she said.
A series of free classes is being offered in Snohomish County to try to get the discussion started on end-of-life decisions. They include who will make medical decisions for you if you are unable to make them yourself, and what medical steps should — or shouldn't — be taken to at the end of life, such as whether you want to be resuscitated or have a feeding tube.
The classes are sponsored by the nonprofit Snohomish County Health Leadership Coalition.
The goal is to have 1,500 people participate in these meetings this year, and then to document their decisions and share them with their physician and loved ones, said Eileen Hanson, pastor at Trinity Lutheran Church and a member of the countrywide health leadership coalition.
Without taking such steps, families are left to make these decisions, often for an elderly loved one who did not communicate his or her wishes on end-of-life issues, she said. “That can leave them with a sense of guilt: Did they make the right decision? Is this what their loved one would have wanted? You're left with another wave of grief on top of the loss of a loved one,” she said.
Snohomish County joins a national effort by communities in this effort, such as the Conversation Project, based in Cambridge, Massachusetts and Choosing Options, Honoring Options, based in Medford, Oregon.
Forms outlining a patient's wishes are a tool to help families talk about and know their loved one's wishes, said Dr. Elizabeth Marshall, a physician at The Everett Clinic.
Among patients who die in the hospital, three-fourths of the end-of-life medical decisions are made by someone else.
Studies show that families are inadequately prepared to know what their loved one wanted, Marshall said. “Conversation, conversation. It's all about the conversation.”
People often define a good death as being pain free and being able to say goodbye to their loved ones, she said. “Those things don't happen when they're intubated and heavily sedated.”
Even with her decades-long experience as a nurse, McDonald, 78, said she found it hard to find the right time to bring up the topic in her own family.
She and her husband, Larry McDonald, took care of his parents for many years. “They had a basic will and that was about it,” she said. An article in a local newspaper on living wills helped her broach the topic. She simply left a copy on the kitchen counter where their mail was left.
She remembers her father-in-law asking: “Did you leave that for me?”
The article discussed how someone could be legally designated to make medical decisions. “It wasn't too many days later when he said, “We think that would be a good idea,'” she said.
Sharon Salyer: 435-339-3486; firstname.lastname@example.org.
Advanced care planning classes
All classes are free, sponsored by the Snohomish County Health Leadership Coalition. The goal of the classes is to allow people to identify their personal, emotional and spiritual values if facing a serious illness and identify what, if any, life-sustaining treatments they would prefer.
Providence Regional Medical Center Everett: 5 to 7 p.m., May 6 or 10 a.m. to noon, May 13, Medical Office Building, Rainier Room, 1330 Rockefeller Ave. Call 206-361-1890 for reservations.
Edmonds Senior Center: 10 a.m. to noon, May 16, 220 Railroad Ave.; 425-774-5555
Marysville YMCA: 1:30 to 3:30 p.m., May 20, 6420 60th Drive NE; 360-653-9622.
Trinity Lutheran Church: 6:30 to 8:30 p.m., May 28, 6215 196th St. SW., Lynnwood; 425-778-2159, ext 2201.
Swedish/Edmonds: 9 to 11:30 a.m., second Saturday of each month, 21601 76th Ave W., Edmonds; 425-771-4548
More information: snocohealth.org/palliativecare/trainings-and-events/attend-event/
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