Richard has had Parkinson’s for more than two decades. He has been hospitalized several times this past year, and each time, his ability to swallow and other motor skills have regressed and have needed to be relearned through therapy. Since there is no cure for Parkinson’s and since Richard has had it for so long, the discharge nurse suggested that Richard’s wife should consider hospice care for her husband.
Richard’s daughter and her husband were visiting from Boston and his daughter discussed the option of hospice with her mother. Therapy has worked in the past and has helped her father regain some of the skills he lost in the hospital. So, what if the same thing happens again and her father has more time than they think? On the other hand, if death is imminent and they know when it will happen, perhaps they can go ahead with hospice care to make him feel more comfortable and his daughter can visit more often to spend more quality time with him.
Now, for people similar to Richard who have had an incurable illness, there may be a way to better pinpoint when someone will die, so that faster and better decisions could be made and more patient interaction with doctors could occur.
Stanford Uses Artificial Intelligence to Determine When Death Will Occur
A team of six Stanford University scientists have used artificial intelligence to predict when people will die in order to improve access to end-of-life care, or specialized care for patients with particularly serious illnesses.
The team uses an Artificial Intelligence (AI) model to devise an algorithm to determine the probability that someone will die within 12 months, taking into account the patient’s medical history and millions of other patient records. Using the tool, the Stanford team of scientists receives a daily report of newly admitted Stanford Hospital patients with a 90% or higher probability of dying in three to 12 months, according to Stanford Medicine. Dr. Stephanie Harman, the clinical chief of palliative care at Stanford Health Care, assesses the report and records and from there advises patients on end-of-life care.
According to Dr. Harman, “[Doctors are] terrible at predicting prognosis. If that information is there [from AI], hopefully that raises the likelihood that the care this patient receives from their health care team matches what they have prioritized. To have care that aligns with what matters most to patients and families — that’s the ultimate goal.” Harman also believes that “(t)he tool helps doctors spend more time with patients and less on record reviews and, most importantly, it leads to better endings.”
The Stanford research is titled Improving Palliative Care with Deep Learning, and it’s currently available online.
Why Someone Would Want to Know When They Will Die
Advance care planning enables individuals to make their own future healthcare choices. It provides direction to healthcare professionals when a person is not in a position to make and/or communicate their healthcare decisions themselves and relieves some of chaos and confusion that accompanies end-of-life care.
We recommend that everyone over the age of 18 have Incapacity Planning documents in place. Included should be an Advance Medical Directive, which includes a Healthcare Power of Attorney that allows a designated loved one to legally make decisions if you are incapacitated, and includes our proprietary Long-Term Care Directive® — that helps you organize, store and disseminate information in order to better serve your future long-term care needs and to guide those who you will depend or for future care. Also critical is a financial power of attorney that grants a designated individual authority to act on a person’s behalf to make financial decisions when that person can no longer make decisions themselves.
But, let’s say you didn’t plan in advance? If families and even doctors are overly optimistic about a loved one’s future, a patient can miss the chance to make wishes clear, if he or she hadn’t done so already. The AI model gives the sickest patients (who hadn’t planned in advance) and their families a chance to talk about what they want to happen, and plan for when they become critically ill.
Advice for When a Loved One is Dying
If you knew your loved one was dying, what would you do different? In a recent Next Avenue article, end-of-life experts share the following advice that they give patients with a uncurable illness. It is surprisingly well-suited for active, healthy people, too:
1. Adjust Your Priorities
Remember, the things that matter most to people aren’t things; they’re other people. If you ask someone who is dying what matters, the answer he or she will likely give will always include the names of people they love.
2. Make Time for Loved Ones
Give priority to your most important relationships. Visit with your loved ones as often as you can. There are some things in life to postpone; however, relationships with those who matter shouldn’t be among them.
3. Have Meaningful Conversations
Most people don’t apologize, seek forgiveness, offer gratitude, or extend feelings of love to their closest friends and family members on a regular basis. They may believe that their feelings are simply understood by their loved ones. Or they may feel that the topics are too significant to broach in everyday conversation, so they keep their feelings inside. It’s worth taking the time to sit with your children, friends, or others you care about and let them know how you feel. Talking about this stuff can be very impactful for you and your loved one.
Prepare in Advance for Incapacity
Two-thirds of healthy people don’t have advance directives, perhaps because it requires them to consider their own mortality. Advance directives are invaluable for everyone, however, since we never know what may happen.
Planning in advance is a way of taking care of your family. It gives the loved one you choose clear authority to speak for you if needed, with no ambiguity. It gives you a chance to convey your values, preferences, and priorities for health care and long-term care so your loved ones aren’t faced with making these decisions for you during a difficult time.
Plan in Advance for Long-Term Care
Do you have a loved one who will need nursing home care in the not so distant future, or who is already in a nursing home? By planning in advance, each person can retain the assets it has taken a lifetime to accumulate and the peace of mind that their family’s needs will be adequately and properly addressed. If you or members of your family have not done Incapacity Planning, Estate Planning, or Long-term Care Planning, or if a loved one is beginning to need more care than you can handle, please contact us as soon as possible to make an appointment for an initial consultation:
Advance Care Planning Fairfax: 703-691-1888
Advance Care Planning Fredericksburg: 540-479- 1435
Advance Care Planning Rockville: 301-519-8041
Advance Care Planning DC: 202-587-2797
About Evan H Farr, CELA, CAP
