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Barbara Bush chooses comfort care at end of life

Written by Diane Archer

Nearing the end of her life, Barbara Bush opted for comfort care, sometimes called “palliative” care.  She chose not to seek medical interventions to treat her congestive heart failure and chronic obstructive pulmonary disease. Rather, she opted for an improved quality of life, with minimal pain. By sharing her decision publicly, she is helping to open up conversations about the value of palliative care that many people are not yet having.

People with Medicare at the end of life always have the choice between medical interventions that attempt to cure a condition and hospice care, which includes palliative care, if they plan ahead. Planning ahead means talking to the people you love about the kind of treatments you would want if you were unable to speak for yourself. Life happens, so these conversations are important for adults of all ages. Considering these choices while you are healthy, sharing your thoughts with the people you love and putting them in writing allows you to ensure your health wishes are honored.

To be clear, choosing palliative care means getting treatment that keeps you as pain-free as possible. It does not mean ending all medical treatment. In Bush’s case, it could mean receiving morphine to address struggles with breathing that come with COPD and diuretics to eliminate extra lung fluid. It likely means foregoing a breathing machine.

Bush had seen the value of palliative care directly. She had once volunteered for the Washington Home, a residence for patients with chronic illnesses. And, Bush had launched its hospice program.

The question you should consider is whether and under what circumstances would  you prefer care to ease pain, along with social and emotional supports over aggressive medical interventions. And you should ask the people you love the same question so that their end-of-life wishes are honored. You should also consider completing an advance directive, a legal document that allows you to put your end-of-life wishes in writing in a living will and to appoint a health care proxy, a person you know and trust to honor your wishes and direct your care if you cannot speak for yourself.

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