End of life issues
Doctor Burggraaff is in favour of patients who discuss and write down their wishes regarding end-of-life planning with the emphasis on the care the patient wants to receive. We call this a POLST (Physicians Orders for Life Sustaining Treatment).
POLST is not for everyone. Only patients with serious illness or frailty, for whom a health care professional would not be surprised if they died within one year, should have a POLST form. For these patients, their current health status indicates the need for standing medical orders. Such a written document is important if you are:
- A person with a serious illness — at any age
- wishing to make clear medical orders for your current treatment
- in favour of instructing and/or limiting actions by Huisartsenpost and Emergency Medical Personnel when available
- in support of guiding your inpatient treatment decisions when made available
Doctor Burggraaff is a strong supporter of:
- advance care planning conversations between patients, health care professionals and loved ones;
- shared decision-making between a patient and his/her health care professional about the care the patient would like to receive at the end of his/her life;
- ensuring patient wishes are honored
When you are in a situation of serious illness take also these points into account:
Doctor Burggraaff is an expert with palliative care. A care that provides you with physical, emotional, and spiritual support. You can get help to relieve pain and symptoms—such as fatigue, anxiety, shortness of breath, nausea, and depression. And you can get help in making a treatment plan.
The palliative care doctor Burggraaff and his practice provides can help you at any stage of a serious illness, including congestive heart failure, kidney disease, multiple sclerosis, or cancer. Many patients who are seriously ill miss the benefits of palliative care. Your doctor wishes to give you the best possible palliative care:
Palliative care improves your quality of life and may help you live longer.
In a study of people with advanced cancer, those who got palliative care early reported better control of pain and other symptoms, compared to people who didn’t get palliative care. People who got palliative care had a better quality of life and less depression. And they spent less time in the hospital.
These same patients who received early palliative care, along with standard cancer treatments, also lived longer than those receiving only standard treatments.
Studies suggest that there are similar benefits for people with other serious illnesses, such as congestive heart failure and multiple sclerosis.
You can get help with difficult decisions.
Your family physician and his team can work with you and your family to:
- Think about the pros and cons of various treatments.
- Talk to your medical specialist about invasive life-support treatments, such as breathing machines or feeding tubes.
- Make your wishes clear to your family or other caregivers.
Start palliative care early for best results.
Don’t wait for your doctor to talk about palliative care. You or your family can request it. Palliative care is most helpful if you start it early during a serious illness. It will have more effect on your quality of care and treatment decisions.
Palliative care is not “end-of-life” care or hospice.
If you are getting palliative care, you don’t have to give up any other treatments for your illness—such as medicines and surgery. Palliative care can be useful, no matter how long you are expected to live.
If you or someone you love is very ill... ask doctor Burggraaff:
Will you talk openly and candidly with me and my family about my illness?
What decisions will my family and I have to make, and what kinds of recommendations are there?
Will you give to help us make these decisions?
What will you do if I have pain or other uncomfortable symptoms?
How will you help us find excellent professionals with special training when we need them
(for example, medical, surgical and palliative care specialists, faith leader, social workers, etc.)?
Will you support me in getting hospice care?
If I reach a point where I am too sick to speak for myself, how will you make decisions about my care?
Will you still be available to me even when I’m sick and close to the end of my life?