Jack, a physically active 79-year-old married man with two adult children and four grandchildren, had been diagnosed with inoperable pancreatic cancer. His oncologist offered him chemotherapy, but weighing the potential risks and benefits, Jack, supported by his 71 year old wife, Margo, decided that he would not pursue treatment. Jack initially had minimal symptoms, but was concerned that eventually he could experience severe pain. Jack’s oncologist suggested that he work closely with a palliative care doctor to help minimize symptoms as they arose.
Margo contacted a patient advocate to help them “put their affairs in order” and think about end of life options. They had drawn up a will many years ago when they lived in another state, and did not have healthcare powers of attorney.
Their patient advocate referred them to a local attorney specializing in estate planning to update their wills and healthcare power of attorney, as well as durable powers of attorney and other estate and tax matters. The advocate listened as Jack talked about his wishes for end of life. His desire was to stay home as long as possible, but he was worried about being a burden to Margo and wanted to make sure she got the support and assistance she would need. The advocate reviewed Jack’s healthcare insurance policy to confirm that they had coverage for hospice care. Then, the advocate toured the local hospice unit with the couple, and helped them discuss in-home vs. in-patient unit care with the hospice intake coordinator. The coordinator also connected the couple with a hospice support group.
