Linda Edmondson on end-of-life care
Linda Edmondson on end-of-life care
By Jim Killackey
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Published: July 20, 2008
Modified: July 21, 2008 at 9:01 am
Linda Edmondson is co-chair of the Attorney General's Task Force to Improve End of Life Care in Oklahoma and a member of the Governor's Hospice Advisory Board. A longtime social worker, she has been executive director of the Oklahoma Association for Healthcare Ethics and program manager for the Oklahoma Alliance for Better Care of the Dying. Before moving to Oklahoma City in 1995, she was the first director of social work at Muskogee Regional Medical Center, where she founded and was the chair of the hospital ethics committee. She is married to Drew Edmondson, state attorney general.
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•Video: Linda Edmondson talks about end of life issues such as health care, hospices, palliative care and what Oklahomans can do for family members near death.
Q: What are some of the controversial issues at the end of life?
A: There is often controversy over whether life-sustaining treatments can be withdrawn if it is determined the patient did not want that sort of treatment at the end of life. Sometimes people think that if something has been started it can't be stopped until the patient actually dies. Actually, it can be appropriate to stop a treatment when it clearly is not having a beneficial effect or when the patient asks for it to be discontinued. Another controversial end-of-life issue is tube feeding. Sometimes artificially administered nutrition and hydration is very helpful when someone is temporarily unable to take food and liquid by mouth. But in other situations at the very end of life, the hydration and nutrition may cause more burden than benefit.
Q: What is a good guideline for end-of-life preparation?
A: The first step is to decide what kind of treatment and care you want at the end of life. If you aren't certain what sort of things might be involved, you may want to talk to your doctor. Your minister may be able to give you guidance about the beliefs of your religion. Second, it is very important to talk to your family, get their opinions and let them know your wishes. Talking to your friends and your health care providers about what you want is important, too. Third, I believe everyone should record their wishes by completing an advance directive. This gives clear information for your family and physicians to use if you are incapacitated and unable to speak for yourself. The advance directive will help show your wishes, and it will name a health care proxy to speak for you if you are incapacitated.
Q: If my doctor is suggesting hospice care, does that mean he or she is giving up on me?
A: No. It means that the goals of care are changing from all-out attempt to cure a disease or condition. Instead, the goal of care changes to providing support to the patient and family as the end of life approaches.
Q: If I have an advance directive, how can I be sure my health care providers will follow it?
A: The advance directive is a legal document and it is in force if you can't speak for yourself. However, health care providers must know that you have one and must be able to get a copy of it. If you have named a health care proxy, your health care providers need to be able to find that person, and the health care proxy should know your wishes and be willing to speak on your behalf.
Q: I understand there is a new advance directive form in Oklahoma. If I already have a living will, why should I fill out the new form?
A: The new form allows your health care proxy to make health care decisions for you any time you are incapacitated. It also covers an end-stage condition like Alzheimer's disease, as well as terminal illness and a persistent vegetative state. There is also clear language about whether or not you want tube feeding.
Q: Where can I get more information about advance directives and the decisions to be made about medical treatment at the end of life?
A: All of the Area Agencies on Aging around the state have copies of the advance directive. So do health care institutions like hospitals and home health agencies. You can get a copy by calling the Aging Services Division of the
Department of Human Services, 521-2281. Online, the directive and other information are available at
okpalliative.nursing.ouhsc.edu.
You can get an information booklet by calling the
Senior Law Resource Center at 528-0858.
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