By Gail Geraghty

Staff Writer

There are so many ways that end-of-life care can become a nightmare, when it’s not talked about in advance. Chances are, heroic efforts will be taken to prolong life, when all that’s wished for is to die in peace, preferably at home.

That’s why Androscoggin Health Care & Hospice believes so strongly that patients and their loved ones need to face up to their final days, the sooner the better. First and foremost, they need to find a doctor who fully understands their wishes, one who will help them fill out an advance care directive.

But that is just the beginning of the conversation.

As one of Maine’s largest home health care agencies, AHCH has become active in a growing national movement to encourage thoughtful end-of-life planning and to lift society out of its fear of talking about death. It has purchased the rights to the film Consider the Conversation: A Documentary on a Taboo Subject, which will have a special showing at the Magic Lantern Theater in Bridgton on Monday, Oct. 20, at 1 p.m.

Following the heartfelt hour-long film, which includes interviews with patients, doctors, nurses and clergy, AHCH will present a panel of palliative care and hospice professionals who will lead a community discussion and answer questions from the audience.

The event comes to Bridgton at the behest of longtime resident Dick Hooper, who helped found AHCH in 1966. He believes the film is a must-see documentary because, while most Americans would say they would hope to die peacefully, at home, surrounded by family and loved ones, precious few people are able to realize that hope.

The reason that hope is not realized, as the film illustrates, has everything to do with a culture that still focuses overwhelmingly on cure, said Karen Flynn, AHCH’s Director of Hospice, who will moderate the event.

“There are so many things that can happen when a person has a sudden change in health status, that even though they may have an advance directive, that voice can get lost,” she said.

Flynn speaks from her own bitter experience. Her father had an advance care directive, she said, but unfortunately it wasn’t very specific. While staying in Florida, his heart stopped, and he was put on full life support in the ambulance. He woke up six days later with his brain function much reduced. Doctors, who hadn’t treated him previously, tried to save him by putting him in an induced coma.

“He died alone, in pain, and really without dignity,” said Flynn. Because the doctors didn’t know her father and hadn’t spoken to him about his wishes, the advance care directive itself wasn’t sufficient grounds for removing the ventilator.

“An ICU doctor will always do everything until the very last breath. And we even see this in our hospice programs — the attitude of, “there’s always something more we can do,” especially with all of the recent advances in treating both chronic and catastrophic illness.

Perhaps, said Flynn, the “something more we can do” is to acknowledge and accept when heroic medical measures no longer make sense, and to switch the focus to patient-centered care. Creating advance care directives that are more specific, and are signed by a physician, is one important step.

Flynn said the Oct. 20 event in Bridgton will be followed up by other similar events around the region, including a gathering on Nov. 7 at the Lepage Conference Center in Lewiston. For more information, call her at 795-9405.