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Personal Stories
An Introduction to Health Care Decisions View 6-minute video clip (6.29mb asf file) Talking with your family. Talking to your family is not easy. They may try to avoid the subject or it may make them uncomfortable. One older woman has tried to talk to her family and is frustrated by their response: "They don't hear you. They don't think it's going to happen." View video clip (86kb file) One younger woman has tried talking to her family without success: "I've tried with my own grandparents, to talk to them, because they're all competent right now, but I think that generation has a hard time talking about it." View video clip (0.14mb file) One older woman expresses her frustration: "All I can say is, I hope I wake up dead." (laughter) View video clip (0.12mb file) One older woman is able to discuss her feelings with her caregivers: "I like living. And if it's something that we could overcome, it would be fine to be resuscitated. But I don't want it is it's going to just mean some more days of nothingness." View video clip (0.36mb file) Click here for tips on talking to your family about your values and your advance directives. Back to Top Talking with your doctor. Talking to your doctor might not be easy. They may be too busy. They might be waiting for you to bring the subject up. One older woman is frustrated by the lack of time to talk: "They don't give you enough time to discuss anything with them." View video clip (80kb file) Another older woman decided to schedule the time with her doctor and brought up the subject for discussion herself: "I made an appointment. And when I went in, I said, 'This is just to talk to you today, and to ask a few questions, and to straighten out a few things.' That's what I did." View video clip (0.24mb file) Some doctors make sure they know what you want by asking you: (Doctor) "Yes, you want be resuscitated; no, you don't want a feeding tube; yes, you want to go to the hospital. And you do want Arlee to be your decision-maker. This is for if you can't tell us, so we know in advance." (Woman) "So they're going to do what they want." (laughing) (Doctor, laughing) "No, no, no. They're going to do what you tell us you want for the future." View video clip (0.35mb file) One woman knows what she wants and is able to tell her doctor: (Doctor) "Do you want to be put on a breathing machine?" (Woman) "No, no." (Doctor) "You've decided no." (Woman) "Well, now here's what I want. When the end is near, I want to be comfortable. I don't want a . . ." (Doctor) "You want to be comfortable and not put on a machine." (Woman) "Yes. I don't want to lay there and just struggle." View video clip (0.37mb file) Click here for tips on talking to your doctor about your treatment choices and your advance directives. Back to Top Not talking may leave your family wondering what to do. Now that their mother cannot talk to them, a brother and sister are not able to ask her what she would want: "My mother never, ever, ever said anything of the sort, along the lines of, "I wouldn't want to live if I were so sick or incapacitated." On the other hand, she never said that's what I would want." View video clip (0.27mb file) A family is trying to talk more now, while they still have a chance: "At some point we are going to cross the threshold when, even if she had a desire, she wouldn't be able to tell us anymore. And that's the point that is the most worrisome to us. When we actually have to make the decisions, as opposed to her, not knowing, really, what she wants." View video clip (0.28mb file) A daughter never asked her mom. Her mom never brought the subject up. Now she is too sick to express her feelings: (Doctor) "And you never said to her, "Mom, do you want to be put on a ventilator if you stopped breathing...?" (Daughter) "Never." (Doctor) "Never....?" (Daughter) "We never discussed it." (Doctor) "And did you ever think about talking to her about it? She's over 90..." (Daughter) "No, I thought she would live to be over 100" (Doctor) "And then she'd just die." (Daughter) "Yeah." View video clip (0.35mb file) When families don't talk about the future, doctors and nurses are left without guidance: (Nurse) "When somebody has been so active and then all of a sudden you have these decisions and like the daughter said - we didn't discuss anything like this, you know. And we hear this all the time, family members of that generation." View video clip (0.30mb file) Click here for tips on talking to your family about your values and your advance directives. Back to Top Doctors talk about talking to their patients. Finding the time to talk is not easy. One doctor expresses his frustration with his busy schedule and lack of time for conversation with his patients: "You spend an hour with these people, and its just totally appropriate, but when you look at the crunch of time in present day, I don't know if we really have the hour-long to talk to families. It's kind of sad." View video clip (0.26mb file) Another doctor wonders what time is the right time to bring the topic up: "At what point do you stop and say, 'OK, we need to talk about it,' and try to find the best time in your medical care for the patient to discuss this. We have never really been taught or its been addressed." View video clip (0.23mb file) A young doctor does not want to frighten her patients: "That's what they always think every time you try to bring it up. That they think, 'Oh, I'm going to die and that's why you're asking me now.'" View video clip (0.10mb file) An experienced doctor also has doubts about talking with his patients: "When I bring it up with a person with chronic illness, and I have to keep bringing it up over three or four visits, then every time this person comes in, I'm talking about their death, when I'm actually trying to so some other things. And so I have some reluctance to bringing that up over and over again." View video clip (0.34mb file) The advances in modern medicine make decisions more difficult for physicians. This makes a discussion with the patient more important: "With modern medicine, defining what is life prolonging, what is comfort, what hastens death, what doesn't hasten death - that's where it starts getting really challenging." View video clip (0.18mb file) This doctor has learned a valuable lesson about the importance of talking and listening: "It certainly taught me something about options. And that you have to sometimes not rely entirely on your past experience but rely on what people are telling you." View video clip (0.27mb file) Doctors must consider the background of their patient when encouraging disucssion: "Differences in culture, differences in religion, differences in philosophical attitudes - I think all of those play a significant part in the decision of not providing care or withdrawing support." View video clip (0.30mb file) Click here for tips on talking to your doctor about your treatment choices and your advance directives. Back to Top Creating an opportunity to talk about it. One older woman expresses her wishes clearly: "To me, death is graduation day. You have lived all these years and now it's a graduation day. And that's what it is to me. And so, I just wish everyone could feel that way, you know, not be afraid when you die." View video clip (0.35mb file) One woman takes responsibility for her own future: "I haven't paid attention to that. And I now know that I have to. I have to be the one to say to the doctor. 'Are you paying attention to what we've written down in this document.'" View video clip (0.24mb file) One family looks back on their experience and gives this advice: "I would say to families that are going through this, that they should find someone out there that they can sit down and talk to. If their own doctor doesn't want to take the time, they should find someone that's an expert on feeding tubes before they decide to put one in their loved one." View video clip (0.31mb file) The doctor can help a person think about treatment options. Doctors will often bring up ideas that a person has never thought of before.: (Doctor) "Let's say your heart stopped. Would you want us to shock it to re-start it?" (Woman) "I never gave it a thought. I never died before." View video clip (0.18mb file) A doctor can help a family think clearly about a complicated subject: (Doctor) "If you were going to be like her, would you want a feeding tube?" (Son) "That's a good question. Probably not." (Daughter) "This is how I feel - if I wouldn't want it done to me, why would I want it done to someone else?" (Son) "Because now we know a little bit more about it, which we didn't know before." View video clip (0.35mb file) When making a difficult decision, it can help to consider a person's values: (Question) "You're not going to do a feeding tube either?" (Daughter) "No way. No. I wouldn't even consider that. I think that's inhumane. Their body's telling them it's time to go, that's why it stopped doing that stuff. No, no, I don't think that's fair at all." View video clip (0.28mb file) When families have an opportunity to discuss things, they know what to do for their loved one: "I just don't want her to be in pain. And I don't want her - I don't know what her mental process is. I don't know if she thinks about anything or if she's in another world. I don't know. If there's a mental process there, I know that Jean would want to let go." View video clip (0.37mb file) |