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Receiving adequate healthcare is a hot topic these days. There are more and more chronic illnesses being discovered and treated with medication and/or specialists.  The information can be overwhelming when we are just struggling to function day to day. I recently conducted an interview with ER Doctor Kevin Haselhorst, MD, an expert on advance care planning, speaks to patients, family members and healthcare providers about advance directives, palliative care and dying with dignity.


Q: Why do you think Americans automatically go to the emergency room when something is wrong?

Americans are easily stressed out and have poor coping skills. They often lack basic resources that support their physical health and spiritual well-being. When they reach out for help, they’re instructed to call 911 or go to the ER.

Q: What are the disadvantages/consequences of going to the emergency room?

Disadvantages: Long wait times, Patients needing to repeat their symptoms 3 times before they see the doctor. Stressful environment plagued with uncertainty, undivided attention is virtually impossible.

Advantages: “One-Stop Shopping” – You can get your CT scan, x-rays, Lab work all done in a relatively short time. It's the next best thing when your doctor can't see you in the office. A quick second opinion with fresh eyes on the situation as well. It's the gateway to being admitted to the hospital and obtaining specialty consults sooner than later.

Q: Working in the ER, you must have seen some intense medical moments. Has this shaped your philosophy on care?

My practice has transformed from wanting to help patients to try to coach them. It's no longer my job to “make it better” – I want patients to feel better about themselves and their ability to manage their own health. What I don't do will come back to haunt me through patients becoming too dependent on doctor's needing to fix everything.

Q: What is strategic aging?

An advance care plan that encourages patients to remain in control of their situations as they age.

Q: Tell us about the 3 part plan that seniors can adopt for strategic aging

  • Prioritize quality of life
  • Manage Chronic Illness
  • Appreciate Palliative Care

 Q: What's the most important thing seniors need to ask their doctors?

What's your personal opinion about the treatment you're offering me? I wrote a 10 Questions patients need to ask doctors.

Q: Do you feel as though these resources are limited?

It's all relative to who's paying for “these resources”. Who's insured and who's not?

Q: How is this approach different to Hospice or another end of life care facility?

A: When all else fails, patients are offered hospice or end-of-life care. Strategic aging is important for those who like to tell others when they're done. Most patients don't want to consider hospice but appreciate not being admitted to the hospital. I prefer patients to assert their self-determination in matters that involve less medical overreach and more quality of life.

Q: What do patients need to know about their healthcare rights that they usually don't?

It's ok to refuse medical treatment/hospitalization. Insanity (Particularly with treating a chronic illness that will never get better) is doing the same thing and expecting a different result. Palliative care supports patients who prefer to leave well enough alone.

Q: What can seniors do to improve their quality of life today?

Take steps to stay as independent as possible. Practice setting goals and achieving them through discipline- like exercising more, reducing stress and improving quality of life. Do something recreational each day.

Q: What can our audience do right now to learn more about Palliative Care?

Imagine Plan B when all else fails – Have them read “Is Palliative care right for you?” And use it's 10 Patient goals and personal values to help them choose medicinal treatments wisely.

Emergency physician, Kevin Haselhorst, MD, an expert on advance care planning, speaks to patients, family members and healthcare providers about advance directives, palliative care and dying with dignity. He’s the author of “Wishes To Die For”, “Is Palliative Care Right for YOU?”, and the forthcoming “The 4 Seasons to Caregiving.”

Dr. H practices at Abrazo Arrowhead Campus. He is a contributing writer for the Arizona Republic’s Ask the Expert Column, publishes Dr. H’s Clipboard: twice-a-month e-tips for advance care planning. He moderates DrH4Caregivers: Support groups on Facebook and LinkedIn where caregivers and healthcare professionals share concerns, post articles and offer support.

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