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Nursing students, medical professionals discuss advance care directives

More people should have end-of-life conversations, participants says

University students, nurses and faculty members held a flash seminar Thursday at the Center for Global Health on advanced care directives.

The seminar focused on the importance of an advanced care directive — or a living will — whereby an individual delegates medical decisions to another agent in the event the individual becomes incapable of active participation in health care decisions.

“You are picking the person who is speaking for you not only when you are dying but when they are trying to figure out if you are dying,” said Cynthia Westley, a patient and family education coordinator at the University Medical Center.

Seminar facilitators spoke to the importance of making advance care decisions early in life. After turning 18 years old, one has the legal right to make decisions about current and future medical care, Nursing graduate student Karen Moss said.

“Once you are over the age of 18, you need to be thinking about this decision,” Moss said.

Misconceptions exist about what an advanced care directive entails and the role of the agent. Facilitators said they hope to reach out to students on Grounds through student health representatives and peer health educators.

Participants discussed how to talk with families about end-of-life medical care. Some suggestions were to discuss past family experiences or current news about the topic.

“End-of-life conversations are the most important and most expensive conversations we are not having,” graduate Nursing student Julia Truelove said.

Graduate nursing student and instructor Michael Swanberg said American culture encourages individuals to spend money on procedures that may not be effective at the end of life.

“We have a culture where we never talk about death, so how are we going to talk about advanced directives when we don’t acknowledge this possibility?” Swanberg said.

Virginia law allows individuals to designate an agent without the need for lawyers or additional documentation. The patient must sign and date the directive with two witnesses.

Martha Jefferson Hospital chaplain Suzanne Smith said patients must take responsibility of their own health care.

“The medical system is like a conveyer belt,” Smith said. “[I]f you want that conveyer belt to take you to comfort measures, you have to say so.”

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