Advancing by Example

May 12, 2012 |

Author Nicole Johnson LCSW

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http://newoldage.blogs.nytimes.com/2009/04/20/why-do-we-avoid-advance-directives/

This article along with a discussion with my fellow JPM Blogger ( Jared Porter) jogged the thought of there being a correlation between clinical providers having an Advance Directive and their patients completing one. While we have not found material to support there is any correlation, we certainly found having the discussion would validate some of the thoughts that clients experience when approached with the request to draft Advance Directives/ Advance Care Planning.

As providers, in most cases, we cannot relate to our client’s experience–whether that is because we have never been diagnosed with Cancer, HIV/AIDS, or even a less serious diagnosis such as Eczema. We can share signs, symptoms, and trajectories based on research and past client, and overall we empathize. There is absolutely no harm there. We can likely relate to our clients that have a goal to lose a few pounds, quit smoking, and or take a daily multivitamin; this certainly a topic where we may not self-disclose but find comfort in providing guidance and support.

This week we challenge those providers/those providers that you work alongside to consider how encouraging clients to complete Advance Directives would be different if you had this personal experience. Would you be more likely to discuss this option if you too experienced the emotions attached to thinking of your final days? Would you be better able to offer support to a client that needs to share their decisions with their family? Would you be able to advocate for your client by understanding how you came to your own conclusions for end of life decisions?

While we have not found formal research on the topic, the age-old “leading by example” provides enough to pose these questions to this week’s blog. If you or colleagues that are working closely with clients on these topics have yet to complete an Advance Directive, please give how a personal experience may/may not influence your approach to encouraging others.

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Jared Porter

Thank you, Nicole! It does seem that having this experience would be very helpful in helping others. I’m eager to hear what others have to say.
VJ Periyakoil

Nicole and Jared:
I agree that for many of us in palliative care, we are “experts without experience” i.e. we do not ( thankfully) have the first person life experience of serious illness. Maybe completing advance care planning may serve as an event giving us a more experiential credibility.
Jared Porter

I would agree. While my work is not clinical in nature, I do hope that, by completing my own advance directives, I can be helpful to others as they begin the process.
Dr. P

I think this is a great set of questions. More people need to empathize. Especially those who have chosen the health profession route for a career. Some people need to love people like they love money.

Journal of Palliative Medicine

Advancing by Example

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