End of Life Care

Congressman Earl Blumenauer has authored The Personalize Your Care Act, bipartisan legislation that will provide Medicare and Medicaid coverage for voluntary consultations about advance-care planning every 5 years or in the event of a change in health status. The bill also provides grants to states to establish or expand Physician Orders for Life Sustaining Treatment (POLST) programs, and ensures that an individual’s electronic health record is able to display his or her current advance directive and/or POLST form.

“This bill will help ensure that every family has the tools, even during difficult and emotional circumstances, to manage end-of-life decisions,” said Blumenauer. “From a young person in a terrible car accident to someone who has had a long life well lived, we all deserve to make our own decisions about the care we want and to have the confidence that those decisions will be carried out.” Despite widespread agreement in the principle that individuals should be fully involved in decisions related to their health care, too often this is not the reality. Most adults have not completed advance directives and even in instances where documents are completed, they may not be regularly revisited and can be difficult to locate when needed. These issues are difficult to discuss and in circumstances where conversations with a doctor has not taken place, families can feel ill-prepared to interpret their loved ones’ wishes. These shortcomings leave people faced with the burden of determining their loved ones’ wishes in the midst of crisis, adding greater stress and anxiety. A study published in the New England Journal of Medicine found that more than one in four elderly Americans lacked the capacity to make their own medical care decisions at the end of life. Under those circumstances, care decisions fall to family members and doctors who may not know the treatment preferences of the elderly patient. Elderly patients with advance directives, however, usually receive the care they chose. Evidence also demonstrates that advance care planning and end-of-life discussions reduce stress, anxiety, and depression in surviving relatives. “Families need the tools and ability to work with health care providers to determine and express their wishes for care in the event that they no longer have the capacity to make decisions.” Blumenauer continued, “This legislation gives providers the necessary time, space, and funding to conduct complex discussions with patients so that can be appropriately cared for. These consultations will ensure that an individual’s values and goals for care are identified, understood, and respected.”

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