Anne Simpson, MD
Anne Simpson, MD, director for the UNM School of Medicine Institute of Ethics.
Credit: Paul Akmajian

In life, goes the old saying, it is the little things that mean a lot. But as we grow older it can be harder and harder to hold on to those small habits and indulgences that make living worthwhile.

Traditionally, the American medical system hasn’t always been helpful to people trying to maintain a lifestyle that provides both dignity and comfort as they age, but a new program at the UNM School of Medicine Institute for Ethics is helping to change that dynamic, said Director Anne Simpson, MD.

“In recent years, as people began live longer, we have medicalized many decisions that used to be private choices. These days, if you are in a long-term care facility, you are going to need a doctor’s order to be able to have a couple of glasses of wine a week or a shot of scotch before bedtime – or to navigate privacy issues like spending time alone with a new – or old love in your life,” said Simpson. 

What one used to do in the privacy of his or her own home can become controversial if a family member takes over health care decision making tasks, said Simpson.

“What if you want to have alone-time with your husband or have sex with your boyfriend?  Are these questions something you would feel comfortable discussing with your children?  If not, who can you appoint to act on your behalf?” she asked.

The U.S. Patient Self-Determination Act mandates health care institutions educate their communities about end-of-life planning issues, yet too often the people who most need the information aren’t being reached, according to Simpson.

To help remedy the situation, the Institute for Ethics formed an Advance Life Planning Task Force in 2014. Since then the task force, which includes UNM and community health care professionals, attorneys and social workers has made presentations to organizations ranging from antique car clubs to homeless shelters, senior centers and neighborhood associations according to Sarah Treviso, the institute’s education and outreach manager.        

The group’s goal is to provide accurate information about what might happen to a person if they have an extended stay in an ICU, become mentally incapacitated or permanently need extreme measures in order to stay alive, said Treviso.

“People need to think, ‘how would I want this situation to be handled? Who would I want to speak for me?’” Simpson said.

Simpson added the presentations aren’t just for the elderly.  

“It is important to educate the people who will be making these decisions. While these can often be difficult conversations, there is a growing awareness across the country about the benefits of this type of advanced planning,” she said.

“I guest lecture for a UNM class, ‘Health Issues of Death and Dying,’ and a class requirement is for everyone to sign advanced directives,” Simpson said. “It is remarkable how many of these students were already thinking about these issues before they registered for the class. They’ve seen elderly family members go through lingering illnesses or had a friend die in a car crash. They have seen the importance of having these types of decisions in place.”