How Living Wills Became a Way of Life in One American Town

With just over 50,000 residents, La Crosse, WI is similar to most other small towns in America – but one thing makes La Crosse stand out: 96% of La Crosse residents who have died had a living will (called an advance health care directive in California) in place. Nationally, the percentage of American adults with some form of advance medical directive, or living will, is only about 30%.

Actually, there are two things that make La Crosse stand out: the town also has lower healthcare costs than any other place in the U.S. And these two things – a high percentage of residents with advance directives and lower healthcare costs — are inextricably linked.

According to a recent NPR story, all this came about because of one man: Dr. Bud Hammes, Medical Humanities Director at Gundersen Hospital in La Crosse. Dr.Hammes often found himself sitting with families of terminally ill patients, trying to figure out what to do next. He said the conversations were excruciating: “Did mom ever say anything to you?” “Do you know what dad wants?” He said that the moral distress of the families was palpable.

Dr. Hammes knew these scenarios could all easily be avoided, since most patients were usually sick for years. So he started training nurses to ask patients early on, if they wanted to sign an advance directive, and over the years planning for death has become a way of life in La Crosse.

And the lower healthcare costs? Dr. Hammes said the reduction in spending was a complete accident; simply a byproduct of letting people make their own choices. He said that when you let patients choose and direct their own care, they often make a much less expensive choice.

You can listen to the entire NPR story here:

NPR: Living Wills are the Talk of The Town in La Crosse, Wis.

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