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Preparing for what ifs

It’s an uncomfortable topic for conversation but it sure can provide some comfort when families need it most.

Last week, Kent Wilson, medical director of Honoring Choices Minnesota, spoke to a group of local health care professionals about end-of-life planning and their role in offering information to patients.

“Planning helps families and being aware of what someone’s wishes are… is a very important thing in our society,” Wilson said.

Honoring Choices Minnesota is a non-profit organization that encourages families and communities to have discussions regarding end-of-life care choices.

It’s a partnership of the Twin Cities Medical Society and its Foundation. They’ve also partnered with Twin Cities Public Television in a public engagement campaign to involve other communities in Minnesota.

Several health care systems in the Twin Cities reportedly collaborated to develop and standardize an advanced care planning program.

During last week’s meeting in Alexandria, Wilson noted that there are basically two steps to answering those “what-ifs” and making your end-of-life wishes known: taking part in advanced care planning and creating a health care directive.


Advanced care planning is a facilitated process that includes conversations about end-of-life care between patients, health care agents and loved ones led by a certified facilitator (usually a health care worker).

“Those discussions reflect on goals, values, beliefs and preferences… in relation to possible health care choices. Perhaps the most important part, as a result of those discussions, are the conclusions… shared with others – family, lawyer, children, spouse, minister, for sure primary care clinic, hospital, nursing home, or any institution or person who may have an interest in this person’s wishes for a medical situation in which he or she couldn’t make their own decisions,” Wilson explained.

That discussion, and resulting decisions, are then boiled down into a document that appoints an agent – a health care directive.


A health care directive is a legal document serving as a basis for medical decisions.

Honoring Choices Minnesota’s website explains: A health care directive states the person’s choices regarding life-prolonging treatments such as feeding, respiratory support and resuscitation. It may include statements about what makes life worth living or beliefs about when life would no longer be worth living. It may include preferences about specific treatment choices regarding care and comfort measures, as well as religious choices and/or organ donation statements.

The nine-page document is free on Honoring Choices Minnesota’s website ( along with more information about advanced care planning.


Wilson said introducing and implementing advanced care planning in a community like Alexandria would require collaboration among health care entities first, then involving the public.

“It takes a whole community of health care folks to organize themselves internally, on one hand, and then, on the public engagement level, it takes persuading a whole community… everybody 18 and above to have a health care directive of some kind. There’s plenty of work in this area,” he said.

Eventually, Wilson said, it would be quite common for health care providers to ask if you have a health care directive.

“It should be as comfortable to have this conversation as discussing whether they took your blood pressure at your annual exam.

“I think as a society, we are moving in this direction, certainly to a greater degree than five or six years ago,” he said.

There’s no word yet on a local health care entity taking the lead on a community-wide program regarding advanced care planning.

Amy Chaffins

Amy Chaffins is a journalist working for the Echo Press newspaper in Alexandria, Minnesota.

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