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Life Care Planning: Preparing for Life’s ‘What Ifs’

Kaiser Permanente leads the way in helping members discuss and document their wishes for future health care decisions.

April 14, 2014

Eugene Chan, MD standing in a classroom with many older adults as students Eugene Chan, MD, leads a Life Care Planning class at Kaiser Permanente Walnut Creek Medical Center, Calif.

On a recent Friday morning at the Kaiser Permanente Walnut Creek Medical Center, about 30 Kaiser Permanente members and their loved ones gathered in a conference room to talk about a subject many people would rather avoid.

They came together for a two-hour class that’s part of a new Life Care Planning service now offered by Kaiser Permanente in Northern California, and soon to be offered in Colorado and Southern California. Life Care Planning helps members think about, discuss and document their wishes around future health care decisions so that those decisions reflect their values and beliefs.

Kaiser Permanente Walnut Creek’s Life Care Planning Director Eugene Chan, MD, led the class. He acknowledged that many people don’t want to plan for serious accidents, illness, or end-of-life issues, but he said even his healthy 20-year-old son should.

Eugene Chan, MD, Kaiser Permanente Northern California

Eugene Chan, MD, director of Diablo Service Area’s Life Care Planning

“It’s sort of like an insurance policy,” he told the class. “You hope you don’t have to use it, but it’s there if you need it.”

Planning for each stage of your life
Kaiser Permanente Life Care Planning is intended to be done in stages — throughout a member’s life.

The first stage, called “My Values: First Steps,” is for healthy adults. The goal is for members to choose a loved one or trusted friend who can serve as a health care agent, someone who can speak for them if they’re unable to do so. They should have a conversation with their agent about their values, experiences and goals around future health care decisions, and complete an Advance Health Care Directive that is entered into their medical record. Advance directives are the plans you make for your future health care decisions in the event you can’t make those decisions for yourself.

The second stage, called “My Choices: Next Steps,” is for people who have a chronic illness and have begun to experience a decline or more frequent hospitalizations. “My Care: Advanced Steps” is for the elderly, or people with advanced illness who may soon be facing questions about life-sustaining treatment options.

Life Care Planning Website screen shot

Melissa Stern, Kaiser Permanente Northern California’s managing director of Life Care Planning, said 50 percent of people are not able to make decisions for themselves at the time of death, so medical teams look to loved ones for answers. That’s why the conversations and planning members do with their health care agent are so important.

“As a health care system, we want to give our members the care they want, but we don’t know what that is unless we ask,” Stern said. “It’s so personal and so grounded in their values, beliefs and experiences — we can never assume we know what someone wants.”

‘We need to be ready’
At all three stages of Life Care Planning, members can work with a trained Kaiser Permanente facilitator who may be a nurse, social worker, health educator, physician or volunteer. Members can request help by contacting the Health Education Department at their local medical center.

The first stage of planning for healthy adults can be done online at Kaiser Permanente’s Life Care Planning website, or in conjunction with a Life Care Planning class.

Tony de Losada and Peggy Watkins

Tony de Losada and Peggy Watkins at the Life Care Planning class

After the Walnut Creek class, Kaiser Permanente members Tony de Losada and Peggy Watkins each gave the session and the presenter, Dr. Chan, two enthusiastic thumbs up. The couple have been together for more than 20 years, and completed health care directives many years ago — but they said this process felt different.

“I didn’t know that I could elaborate more and add more descriptions, phrases and ideas about what I really wanted,” de Losada said.

Watkins said she was pleased that Kaiser Permanente is providing this service.

“I know this is coming, and we need to be ready,” she said. “I don’t want to make it hard on my children, or anybody else in the end.”