Rock Center   |  December 06, 2012

Talking about death brings end-of-life benefits

It’s one of the most important conversations a family can have, yet so many families fail to have it until it’s too late. Rock Center’s Harry Smith goes to a Wisconsin hospital that has its patients talking about the inevitable: death. In the process it has become known as the best place to die in America.

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This content comes from Closed Captioning that was broadcast along with this program.

>>> our next report here is one of those things a lot of american families should see because it's about a moment in life all families face. tonight, you'll see something remarkable going on at a hospital in wisconsin that has developed a humane and life-affirming way to face what we all eventually face and that is the end of life . just as remarkable as you'll see are the families who allowed harry smith to join them in the conversation.

>> reporter: people come to the emergency room to have their lives saved.

>> resuscitation complete.

>> reporter: but as americans live longer and longer, the emergency room is not the best place to begin a conversation about how you want to live the rest of your life or even how you want to die.

>> do you know where you are?

>> reporter: tough choices about which treatments and how much treatment become a guessing game , often powered by guilt.

>> one family member may say, no, we need to do this, we have to do everything. and another family member that is saying, we just have to make her comfortable.

>> reporter: but that disagreement rarely happens in what might just be the best place to die in america, lacrosse, wisconsin. here in this hospital, an astounding 96% of the patients have a game plan for life and death . it's called an advanced directive. it starts with a very tough, very honest meeting they call next steps.

>> tell me what you know about paul 's condition.

>> he's not going to get better. and we know that.

>> paul , what do you hope for with your current plan of care?

>> give me as much time as i can get, but keep me comfortable.

>> reporter: paul and gene pearson have been married 21 years, a second marriage for both. together they have six children. he's a 73-year-old retired architect. she was an interior designer . this is what real love and devotion looks like.

>> if you were having a good day, what would that day be like?

>> i'd probably be fishing.

>> you'd be fishing.

>> and she'd be with me. she's more important to me than anything.

>> reporter: paul pearson has inoperable lung cancer . he and jean don't want there to be any doubt about how he wants to live out the rest of his life.

>> this discussion --

>> reporter: in this meeting, run by jack si, a nurse practitioner, paul and jean face their decisions head-on. we were there to witness the process, which is as emotional as it is profound.

>> paul , what worries you about your illness? what fears do you have?

>> breathing is going to be a probl problem. and probably having to go into a nursing home .

>> what about going to a nursing home ?

>> being stuck there. i don't want to be a burden to her.

>> reporter: paul is emphatic. he doesn't want to linger or suffer. and he is not afraid to say so by refusing treatment.

>> what i'm going to do now is read through these situations. if i have a serious complication from my cancer or treatment for my cancer so that i was facing a prolonged hospital stay and my chance of living through the complication was low, for example, only 5 out of 100 patients would live --

>> i would deny treatment.

>> it was expected that i would never either walk or talk or both and i would require 24-hour nursing care --

>> it would be the same answer.

>> it was expected that i would never know who i was or who i was with --

>> same thing.

>> and i'm in agreement with that.

>> reporter: looking ahead to the end of life is a journey that takes no small amount of courage. and what happens in this meeting is as important for jean as it is for paul .

>> this is really a gift that you're giving to your family because at some point, if they're needing to make a decision, they can go back to this and say, yes, this is hard, this is difficult, but this is what mom or this is what dad really wanted.

>> take a deep breath for me.

>> reporter: one of the things they've learned here is all this talking about how you want to die, in many cases, helps people live longer and incredibly enough costs less. at gunderson , patients in the last six months of life spent half as days in the hospital as the national average. but this doctor led the gunderson team that came up with this better way to die.

>> when we are dealing with patients who have getting sicker, they reach a point where they know there isn't much more, they say, i'd like for you to keep me comfortable. the cost f of care goes down because we're not doing all these expensive things they don't want.

>> some people will say, it looks like they're trying to talk people out of care.

>> that's not the philosophy. we really want to understand the patient's perspective. we want to understand the patient's values.

>> reporter: and planning ahead has another benefit -- peace. when it's time to go, there is little rancor or remorse.

>> hello, eva .

>> reporter: while we were at gunderson , we met the foote family, just the week before, 90-year-old eva foote was at a fair.

>> i know what you wanted for her was for her to be comfortable.

>> reporter: but severe stomach pain brought her to the emergency room . eva had a life-threatening blood clot in her intestines. they had a roadmap which led them to forego surgery because doctors found eva 's chances of regaining anything close to her former health were next to none. your parents led you know ahead of time what they wanted to do.

>> yes.

>> knowing ahead of time it takes a load off the family.

>> reporter: two days later, eva passed away peacefully. her wishes honored. for paul pearson 's children, the plan was tough to take at first. but now that they know what he wants, they have accepted it.

>> it does put everybody at ease.

>> to know that there is this plan in place.

>> yeah, it really does. all of us can be prepared for each step as it comes.

>> reporter: the pearsons don't feel like victims of their circumstances. in fact, just the opposite. the process has helped paul decide how he wants to live the rest of his life. on the schedule, more fishing and historical re-enactments. jean and paul have been going for years, and now is not the time to stop. how helpful is it to have these conversations, to go through the scenarios ahead of time?

>> this gives us that advantage that we don't have to be second-guessing, what should i do? we've already made those decisions. and they're hard decisions. but we're okay with them.

>> our thanks to harry smith but also to paul and jean pearson who we happen to know are watching our broadcast at home tonight . they allowed us to join in their life-changing conversation. thank you on our behalf for sharing