The recent terminal illness and death of a friend has me thinking about the encounters most of us will have with the health care system at the end of life. It seems to me that no time is more important – or potentially more challenging – to exercise control of the health care services we receive. A recent article, “We’re Bad at Death. Can We Talk?” by Dr. Dhruv Khullar drives this point home.

The key to having our health care preferences respected at the end of life is to get clear about what they are and then document them in an advance directive. An advance directive is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. Without an advance directive, health care decision-making often skews to “doing more”, when doing less but with good pain management may be what patients would have preferred.

There are some great resources to help us with the process of creating advance directives for ourselves or our family members. The Conversation Project, co-founded by Pulitzer Prize winner Ellen Goodman, helps us take the first step by identifying and then talking about our preferences for end of life care.

The website includes easy to understand and use conversation starter kits – available for free in several languages. There are special versions that address Alzheimer’s Disease and other forms of dementia as well as seriously ill children. There are also how to guides about talking with your doctor and choosing (or being) a health care proxy.

These would make great additions to your library of employee health care resources!


Cheryl DeMars

Cheryl DeMars

President & CEO at The Alliance
Cheryl DeMars joined The Alliance in 1992, assuming several roles before becoming CEO in December 2006. Cheryl works with the Board of Directors and senior leadership team to establish the strategic direction of the cooperative.

Cheryl participates in a number of national and regional initiatives that align with The Alliance’s mission of controlling costs, improving quality and engaging individuals in their health. She serves on the Advisory Board of the Wisconsin Population Health Institute and the board of the Wisconsin Collaborative for Healthcare Quality.

Prior to joining The Alliance, Cheryl was a program manager at Meriter Hospital in Madison. She earned a master’s degree in social work from the University of Wisconsin-Madison.
Cheryl DeMars

Pin It on Pinterest