Advance Care Planning Now Possible Under Medicare

Effective January 1, 2011, seniors will have the option of voluntary advance care planning under the Medicare benefit. This same benefit was initially included in the original health care overhaul, but opponents successfully abolished it from the initial reform bill with a public outry labeling the practice “death panels” and calling it “government-sponsored euthanasia,” according to End-of-life discussions

Some say that opponents of the reform bill merely took the opportunity to turn the public against health care reform. Others say that encouraging and funding end-of-life discussions may lead seniors to forego life-sustaining or life-extending treatments they may otherwise have opted to receive.

Encouraging end-of-life talk is not new in the healthcare industry. In the past decade, pioneers have stressed the importance of educating the public about their options when it comes to end-of-life treatments and encouraging them to make their own choices about the treatments they choose to receive. It’s standard practice in many assisted living facilities and nursing homes for social workers to aid residents in end-of-life planning.

Any adult can legally elect to receive — or not — different types of life-sustaining treatments in the event of terminal illness or catastrophic injury. These documents are referred to as advance directives, living wills, or “Do Not Resuscitate” orders. Laws on these documents vary from state to state, as do the specific meanings of the terms.

In some instances, a “Do Not Resuscitate” order simply indicates a person does not wish to receive cardiopulmonary resuscitation (CPR) or advanced cardiac life support if the heart stops beating, while an advance directive or living will — in most cases — details the different circumstances under which an individual wishes to receive a variety of life-sustaining treatments, such as intubation (feeding tube) or being placed on a ventilator.

The new regulation will enable seniors to (at their own choosing) consult with a physician and receive assistance filling out end-of-life forms. The question at the center of this debate is whether or not such discussions will cause seniors to feel pressure to opt out of treatments they actually want.

What are your thoughts on the subject? Do end-of-life discussions discourage seniors from receiving life sustaining treatments or serve as a means to educate on the options and empower seniors to make their own decisions?

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