Free Daily Headlines :

  • COVID-19
  • Vaccine Info
  • Money
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Vaccine Info
    Money
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

How do you want to die? Write it down …

  • Health
  • by Mackenzie Rigg
  • November 26, 2017
  • View as "Clean Read" "Exit Clean Read"

Mackenzie Rigg :: Connecticut Mirror

Karen Mulvihill is Danbury Hospital’s director of palliative care services and co-chair of Care Decisions Connecticut.

Everybody dies.

How we die can be a very complicated and emotional topic. But there are ways to make it easier on yourself and your loved ones, including writing down the type of care you want to receive at the end of your life.

Last April, the Connecticut Hospital Association launched Care Decisions Connecticut, a statewide initiative aimed at increasing public knowledge and awareness about end-of-life planning and implementing best practices for providers across Connecticut.

The group includes representatives from hospitals, state agencies and insurance companies, as well as long-term, home, hospice and palliative care. The group has a website and held an event in April that drew more than 100 practitioners, patients and advocates.

Karen Mulvihill is the group’s co-chairwoman, and as a nurse practitioner and the director of palliative care services at Western Connecticut Health Network, she sees families struggling every day over the care they believe their loved one would want, especially if that sick person is not able to speak for himself or herself.

In this Sunday conversation, the Mirror sat down with Mulvihill to get her thoughts on Care Decisions Connecticut and end-of-life planning.

Click to read others

Why is Care Decisions Connecticut needed?

Only about a quarter of our population actually has an advance directive. Working in palliative care, the challenge really comes up when patients come into the hospital, they’re seriously ill and they don’t have their wishes known to their family members.

Now we’re having to have a conversation with them about what are your wishes now that you have a serious illness. Do you want us to be aggressive? Do you want us just to focus on your comfort?

When the patient can speak for themself, that’s great because we can take that and go with it, but when they can’t, the patient’s voice can’t be heard and the family assumes they know what they want for the patient, but they don’t always know that. Also, there’s discord among family members a lot of times as well.

Having a piece of paper with their wishes written in their handwriting signed by them is something concrete to take to the family … so it is really a gift to families.

What is an advance directive?

In Connecticut, an advance directive consists of two documents. One is a living will, and the living will is your wishes under three different conditions: if you’re terminally ill, if you’re permanently unconscious, or if you’re in a persistent vegetative state. [The living will] asks what you’d want during those — would you want CPR? Would you want us to put in a breathing tube? Would you be okay with artificial means of nutrition and hydration? And then it has an area to talk about what other things you might not want.

The second document, which I think is even more important in an advance directive, is assignment of a health care representative. We get a lot of patients who don’t want to do the living will part. The importance of assigning a health care representative is that it’s who you are actually saying you want to make decisions for you.

Connecticut has next of kin laws as well, which say your spouse is the first person we’re going to go to, adult children, parents, siblings and it goes down from there.

Some people might not want their spouse to be their decision-maker. Maybe they’re too emotional, and they are not going to be the one that follows through on what their wishes are. So they assign somebody else. That health care representative can override everybody, as far as their wishes.

People tend to think of advanced care planning for older people who have serious illness. I have an advanced directive and I’m in my 40’s. I have one, my husband has one.

Having a piece of paper with their wishes written in their handwriting signed by them is something concrete to take to the family … so it is really a gift to families.

Karen Mulvihill
Director of Palliative Care Services at Danbury Hospital

How has Care Decisions tried to get the word out about advanced directives?

We had a kick-off event in April for National Health Care Decision Day, where we had an all day conference at CHA to talk about the importance of advance care planning.

We had a few speakers, including a family member, who went through the experience and was able to talk about the importance of having that document.

We talked about the Conversation Project. I am a huge advocate for the Conversation Project because it puts it in the patient’s hands.

Most patients when asked want to have a discussion with their family members about their wishes at end of life but they don’t know how to start that conversation.

The Conversation Project developed this whole program for patients, for the community, to be able to say this is how I can start having this conversation with my loved ones — and how to word it, how to start the conversation, when to have the conversation, how to find the documents … and how to go onto your physician.

What we find, clinicians, primary care providers, are waiting for the patient to bring it up to have that conversation. Meanwhile the patient is waiting for the clinician to bring it up.

At that same time in April, we launched the website, which is a great site for everybody, in multiple languages, that talks about why advance-care planning is important. It talks about palliative care and hospice care and who qualifies for those. Resources are there, including links to the Conversation Project.

You said most people want to have the conversation. What advice do you give on how to start that conversation?

I think people should have the conversation when they are well, and that we should all be thinking about this. Make it just a normal conversation. To have the conversation at the moment of crisis is much more difficult for everybody.

The best way to approach that conversation — there are many different paradigms out there for having it. There are these “death with dinner clubs.” They will go out to dinner, have a little wine, bring all the copies of the documents and talk about it with each other.

But if it’s something that’s difficult, I think a good approach is saying, “Mom or Dad, I really need your help with something. I really need to know what you would want me to do in this scenario if you weren’t able to speak for yourself.”

How do you get the younger populations to have the discussions about themselves?

That is a challenge. They think they will live forever.  I think just normalizing the conversation, and maybe pulling in technology to help may be a way to keep them engaged.  But I don’t know of anything out there like that.

What response have you gotten from your patients and their families after they completed advance directives?

Relief. They are relieved that they were able to talk about it.

Years ago, I had a couple who just could not talk to each other about their wishes. One of them had a serious illness, and it needed to be discussed. They would each talk with me, without the other present, about what they wanted.

I offered to bring them together and help facilitate a conversation about their wishes. They felt relieved to have it out in the open and were able to keep the communication going even after we completed the advance directive. I was able to use the paper as a tool to facilitate their discussion.

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Mackenzie Rigg

SEE WHAT READERS SAID

RELATED STORIES
Can independent primary care doctors survive dominance of hospital health systems?
by Peggy McCarthy | C-HIT.ORG

hospital systems and private businesses are increasingly buying private medical practices and taking over their business operations.

Nearly three quarters of eligible CT residents expected to be vaccinated by end of April
by Jenna Carlesso

Since Thursday, 50,000 residents age 16 to 44 – the newest group granted access – received a first dose of the vaccine.

With demand for community health workers rising, so does need for sustainable funding
by Cara Rosner | C-HIT.ORG

New Haven Community Health Worker (CHW) Katia Astudillo helps dozens of her clients navigate the logistics of getting vaccinated and connects them with other health services. She even helps them find rental assistance. In and around New London, CHW Lizbeth Polo-Smith hands out flyers about COVID-19 safety and vaccinations at churches, laundromats, stores, warming centers […]

The vaccine effect: COVID cases jump, not hospitalizations or fatalities
by Mark Pazniokas

Officials credit Connecticut’s success in vaccinating older residents for keeping the COVID-19 death rate low as cases rise.

More than 1,800 people could get vaccinated at home under new DPH program
by Dave Altimari and Jenna Carlesso

Residents who wish to receive a vaccine at home must assert they are physically unable to get to a clinic.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion A healthcare system too broken to fix
by Sosena Kedebe MD

On March 25, the White house announced that it was going to invest over $6 billion in health centers that are funded through the Resources and Services Administration (HRSA) in order to expand COVID-19 vaccinations and other health services provided to vulnerable populations. As a chief medical officer for a health center that is strained to reach some of the most disenfranchised patient population in Hartford, this was great news. Yet there was a part of me that took the news with a deep concern. Why you might ask?

Opinion The Connecticut Juvenile Training School and the lie that built it
by Colleen Shaddox 

Sitting in the paddy wagon, I was afraid – maybe apprehensive was a better word, since I rightly suspected that white privilege would guarantee me good treatment.  Still, I said a prayer of thanksgiving. After years of advocating for people in our carceral system, I was given a chance to develop more empathy.

Opinion Data on race, ethnicity and language is critical to making real healthcare progress
by Vicki Veltri, Tekisha Everette and Matt McDermott.

There are significant disparities in health status based upon race, ethnicity, and other factors that deprive many Connecticut residents of an equal opportunity to enjoy good health and well-being. That some Connecticut residents live without proper treatment of illness and injury due to disparities in health care access, affordability, and outcomes based upon race, ethnicity, and language (REL) is self-evident to many but not to all.

Opinion SB 1018: Connecticut’s effort to increase prosecutorial accountability and why it will not work
by Olivia Louthen

Senate Bill 1018 does not solve Connecticut’s largest criminal justice problem: outcomes for crime victims and defendants vary based on zip codes because judicial districts operate independently of one another.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO