Conference on dying to focus on talking about the inevitable

TULSA, Okla. (AP) -- Flinn Cremin has seen the difficulties families face when a loved one dies.

"It often is more than the senses can bear," the nurse of 27 years said.

That's why Cremin recommends relatives talk about last wishes before anyone in the family dies.

She and others are participating in a conference on Friday at Oklahoma City Community College that focuses on care for the dying.

She will train nurses from other communities on how to start programs that get families to talk about death before a tragedy strikes a family member.

Cremin remembers one case in which a father in his mid- to late 40s came into the emergency room after a serious car accident.

Doctors told the man's three sons that their father no longer had brain activity.

More than a week later, there was still no sign of brain activity, and a ventilator was keeping the man alive. With their mother already dead from cancer, it was up to the three sons to decide when -- and if -- to take their father off the ventilator.

The boys had never really talked about the subject with their father and were having a hard time coming to a consensus.

"It would have been much easier on the family if he had any kind of advance directive or if he'd have talked to the family,"

Cremin said. "But who wants to talk about that?"

While most people do not like to talk about death, Cremin said filling out an advance directive makes decisions easier on the family.

Advance directives can specify whether a family member wants to be put on breathing machines, fed through a tube or resuscitated if his or her heart stops.

The importance of making end-of-life decisions before trauma or fatal illness strikes is one of several topics discussed at the annual conference, sponsored by the Oklahoma Association for Healthcare Ethics and the Oklahoma Alliance for Better Care of the Dying.

The conference also will look at the affordability of hospice care and the sensitivity of doctors.

Steve Orwig, a doctor with the Department of Veterans Affairs Center in Oklahoma City, will lead discussions on the sensitivity of doctors. Orwig said doctors often tell people bad news using "doctor babble," or just telling them their family member is dying, then going straight to talking about the patient's options.

Orwig said doctors have to learn to give family members time to absorb news and allow grief to begin.

"The key is something where we need to let the family members be the guide," Orwig said.

The issue of hospice-care affordability will be discussed by Linda Edmondson, executive director of the Oklahoma Association for Healthcare Ethics. Edmondson said she thinks hospice care should be an available option to anyone who is dying because it often puts them in a more comfortable environment.

Cremin agreed that hospice care should be available to everyone.

She said cases vary, but for the terminally ill, dying under hospice care is often a better option than struggling to stay alive at the hospital.

"You want to make sure your life is what you're prolonging and not your death," Cremin said.

The registration deadline for the Oklahoma Association for Healthcare Ethics conference is Monday. The cost for nonmembers is $100.

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