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Virginia Sen. Mark Warner aiming to normalize end-of-life health care conversations

Friday, Mar. 29 | By Trevor Baratko
U.S. Sen. Mark Warner led a round table discussion on advanced illness and late-life planning March 27 at the Loudoun County Public Schools administration building in Ashburn. The discussion focused around Warner’s Senior Navigation and Planning Act. Photo by Beverly Denny
For the last 10 years of her life, Marjorie Warner didn't say a word. She couldn't.

Crippled by acute Alzheimer's disease, Warner, the mother of U.S. Sen. Mark Warner (D-Va.), was like millions of older Americans who lose their independence in the final chapter of life.

And like millions of families, the Warners didn't aptly prepare for dealing with such a debilitating condition and what comes next. They never had the conversation, the senator said.

"I know firsthand the challenge of ensuring that loved ones with advanced illnesses not only get the best care possible -- but also the care that they want," Warner said Wednesday in Ashburn.

Given the senator's dispiriting experience with his mother and the countless stories he's heard from constituents, Warner again plans to introduce this year the Senior Navigation and Planning Act (SNPA), intended to help families and individuals better plan for late-life treatment. A key mission of the proposal is to ensure the wishes of people with advanced illnesses are respected, according to the senator's office.

This year will be the third time Warner takes SNPA to the Senate.

Bullet points of the initiative call for: enhanced Medicare and Medicaid coverage for advanced illness care management services; requiring physicians to provide certain Medicare beneficiaries with information on advance directives and other planning tools; providing incentives for providers to achieve accreditation and certification in hospice and palliative care; and increasing public awareness about the importance of end-of-life planning.

In Loudoun County this week Warner headlined a round table discussion with more than 30 health care professionals. The group touched on SNPA and the challenges facing workers on the forefront of health care.

Dialogue must be the first step in dealing with late-life care, panel members and the senator agreed. A need for heightened communication and information dissemination springs from the statistic that 80 percent of Americans will at one point not be able to make late-life health care decisions for themselves, according to Warner.

“It's remarkable to me that America may be the only advanced nation in the world that hasn't had a real adult conversation about this issue,” Warner said.

Warner recounted the myths and misinformation and notorious “death panel” comments during debate over the now-passed Patient Protection and Affordable Care Act, often referred to as Obamacare. The senator wondered how getting "informed advice was somehow branded death panels."

Attendees of Wednesday's event – representatives of regional hospitals, hospice facilities and other fields with a link to health care – appeared on board with Warner's proposal. Many voiced support for an educational campaign that explains why having conversations with loved ones about an aging plan is so essential.

Semantics also factors in, panelists agreed – viewing the conversations as life-planning rather than death-planning is critical; and “normalizing” the discussion must be a goal.

Warner noted, “End-of-life is not the way to describe this issue, because it sets off ideas of government coming in and taking away somebody's rights or somebody's ability to get the treatments they need.”

Warner expressed optimism 2013 could be the year SNPA gains Senate approval. A spokesman from his office said there have been increasing signs of bipartisan cooperation in Congress' upper house this year, and "the hyper-partisan dysfunction of the past couple of years has started to wane."

Virginia's senior senator's SNPA has been endorsed by the American Association of Retired Persons (AARP), the National Hospice and Palliative Care Organization, the Alzheimer's Foundation of America and Duke University Divinity School's Institute on Care at the End of Life.

Warner's Loudoun visit came two days after he made headlines for an unrelated issue. On Monday he fully endorsed gay marriage and equality for same-sex couples, a hot-button issue at the root of two Supreme Court cases heard earlier this week.

“I support marriage equality because it is the fair and right thing to do,” Warner announced Monday on Facebook. “Like many Virginians and Americans, my views on gay marriage have evolved, and this is the inevitable extension of my efforts to promote equality and opportunity for everyone. I was proud to be the first Virginia governor to extend anti-discrimination protections to LGBT state workers. In 2010, I supported an end to the military’s ‘don’t ask, don’t tell’ policy, and earlier this month I signed an amicus brief urging the repeal of Defense of Marriage Act.”
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