As I Lay Dying: Several Utah organizations are helping individuals navigate--and plan--their final years, months, and hours.

• Author: Beers, Heather

Machines blaring the electronic rhythms of life hang in the balance. Physicians and nurses whirl in and out. The desperate urge to focus on memories of times past gives way to a frenzy of questions and fears about an uncertain future.

When someone you love faces an end-of-life crisis, the last thing you want is to help them make last-minute decisions about their care. Do they want to be resuscitated should they experience cardiac arrest? How long do they want to be kept on life support if things take a turn for the worse? If the end is imminent, would they prefer to stay in the hospital, go to a care facility, or have hospice care at home?

It's easy to see why all of these decisions should be made before a crisis hits, but according to a Health Affairs study, only about one-third of Americans have completed an advance directive. That means two-thirds are avoiding important decisions about one of the most critical stages in life, which is likely to complicate an already complicated situation.

I'll admit that I'm among the two-thirds-and I should know better. I've been through the agonizing experience of watching a loved one face end-of-life care. I've seen the questions that arise, the subtle discrepancies between what family members think is best, and the tough calls that have to be made. But I'm afraid I'd rather procrastinate it all and focus on the day-to-day--family, work, gym, what's for dinner--rather than imagine what course I want physicians to pursue if (when) I find myself on the brink.

For the last few years

In Utah, a collective of organizations are helping healthcare providers and policymakers make headway in navigating the passage from life to death. That's why Comagine Health created www.leaving-well.org, a website now maintained by the Utah Hospital Association dedicated to walking Utahns through all aspects of planning for end-of-life care.

"The website is really to ensure that people in Utah have the opportunity to live well to the end of life. That's where the 'leaving-well' name came from. We wanted to focus on sharing their conversations about end-of-life goals with their healthcare provider, empowering them to make this conversation easier," says Deepthi Rajeev, director of Utah patient safety and innovation for Comagine Health, a national nonprofit healthcare consulting firm.

Beyond its support of the website, the Utah Hospital Association is adding its expertise and energy on several fronts. "There's very little...