Life Matters Media
Quality of life at the end of life

Mayor Emanuel Starts the Conversation in Chicago, Urging Expression of End of Life Care Plans

Marking National Health Care Decisions Day on Tax Day, Residents Address Life’s Two Certainties

LIFE MATTERS MEDIA STAFF

Chicago Mayor Rahm Emanuel issued a proclamation to mark National Health Care Decisions Day.

Chicago Mayor Rahm Emanuel is encouraging all Chicagoans to make their future health care wishes known during a week of events to educate residents about the importance of advance care planning, the process of considering, communicating and documenting end of life care choices.

Advance care planning is shown to be the most effective way to ensure that actual care received aligns with personal preferences.

Responding to a request from Life Matters Media, a local resource providing support for those facing end of life decisions, Emanuel issued a proclamation to mark National Health Care Decisions Day on April 16. Now in its 10th year, the initiative encourages those of every age and stage of health to express their wishes regarding health care and for providers and facilities to respect those wishes, whatever they may be.

“National Health Care Decisions Day will help the residents of Chicago understand the importance of making their wishes known ahead of time with the hopes that fewer families and health care providers have to struggle with making difficult health care decisions,” Emanuel declared.

According to the Centers for Disease Control, 60 percent of Americans say it is “extremely important” that their loved ones are not burdened by care decisions. However, less than one-third of adults are estimated to have had a conversation about end of life wishes.

National Health Care Decisions Day is traditionally held the day after the filing deadline for federal income tax returns, coupling the two events that Benjamin Franklin explained to be inevitable in his famous quotation: “in this world nothing can be said to be certain, except death and taxes.”

Emanuel has asked that every Chicago hospital, nursing home, assisted living facility, retirement community and hospice participate in this engagement effort through providing clear information about planning ahead for health care.

In collaboration with the City of Chicago Department on Aging and the Chicago Public Library, Life Matters Media facilitates year-round advance care planning and educational programming about end of life discussions, advance directives, hospice, palliative care and organ donation.

‘National Health Care Decisions Day will help the residents of Chicago understand the importance of making their wishes known ahead of time with the hopes that fewer families and health care providers have to struggle with making difficult health care decisions.’ — Chicago Mayor Rahm Emanuel

To mark this initiative, the nonprofit is hosting the creation of “living well” murals in some of Chicago’s most public spaces, including the James R. Thompson Center (State of Illinois building) and Northwestern Memorial Hospital’s Feinberg Pavilion. All residents are invited to visit one of the on-site creations and share their goals for living well at every age. They can then watch as their words and phrases come to life in illustrative visuals.

“We hope our murals are a method to animate advance care planning and to make the process more palatable and lively,” said Life Matters Media president Randi Belisomo. “I would much rather discuss how I hope to live well than how I hope to die. It’s a more values-driven framework, instead of a checklist of treatment options we want to avoid. If Chicagoans can discuss hopes for how we wish to live, our loved ones will have solid guidance if care decisions need to be made.”

Belisomo said that too often, end of life planning is reduced to considering combinations of complex medical scenarios that will likely never unfold. Those scenarios don’t offer the best information to those selecting treatment options, because the possibilities that could arise are endless.

While the discussion of goals with loved ones and providers is the priority on this day of health engagement, Emanuel noted the many options from which Illinois residents may chose to document their wishes. The Illinois statutory short form power of attorney for health care is available for free download through the Illinois Department of Public Health. It is valid upon the signature of the person documenting wishes and that of a witness. It does not require an attorney or notary public.

The vast majority of Americans say it is important to put their end of life care wishes in writing. Less than a quarter have actually done so.

For those who are seriously ill, the Practitioner Orders for Life-Sustaining Treatment (POLST) is also available to Illinois residents. The POLST travels with a patient to assure preferences are honored across settings of care, such as hospitals, nursing homes and rehabilitation facilities. Because it is a medical order, which differs from an advance directive, it requires the signature of a medical provider. More information is available at postil.org. The document is free to download in English and Spanish.

The overall purpose of such forms is to help ensure end of life wishes are carried through during emergencies or hospitalizations, when patients may be unable to speak for themselves. Ideally, an advance directive should be a living document that is updated as one’s health and relationships change.

According to the California Healthcare Foundation, 82 percent of Americans say it is important to put their end of life care wishes in writing. Only 23 percent have actually done so.

“End of life issues are among the few health challenges that impact every person in every family,” Belisomo said. “We all have a stake in improving the end of life care in our own communities.”

On Wednesday, April 18, Life Matters Media will create a mural that travels through the city’s Chatham community. It will make stops at two senior centers and the 87th Street Center, a shopping plaza at the Dan Ryan Expressway.

With the support of the Retirement Research Foundation, the organization is in its second year of developing a structured advance care planning program with multiple sites of service to assist Chatham residents with end of life planning needs. The South Side neighborhood is home to one of the largest populations of older Chicagoans living alone, and the nonprofit has worked to create a trusted and culturally competent resource for seniors to discuss issues that they have long worried about– but never voiced.

“We hope this project can emerge as a community model for meaningful dialogue about end of life,” Belisomo said. “While dying in America is undoubtedly difficult, these difficulties are exacerbated when dying as an African-American. We are grateful to our supporters and to the Retirement Research Foundation for working to eliminate this disparity that divides us in death.”

Research has shown that African-Americans report worse symptom suffering than white patients at the end of life. African-Americans suffer from more pain and worse communication with their physicians about end of life care choices.

To have an end of life discussion with loved ones, a “Starting the Conversation” guide is available online.


Mayor Rahm Emanuel: Make Your Future Care Wishes Known