Sharon S. Richardson Community Hospice - Sheboygan, WI

Something to Talk About

Something To Talk About, by Angelia Neumann
(published in The Sheboygan Press May 2014 MOXIE edition)

Have you heard of the city “where everyone talks about death”?  Much like Sheboygan, the city’s waterfront is bustling with interesting shops and restaurants.  There are three great colleges and a plethora of bars.  Access to quality healthcare, education, employment and entertainment abound.  Most would say that La Crosse, with its 50,000 residents snuggled up against the Mississippi River, is a happy place to live.  So why have our neighbors across the state become so obsessed with morbidity?  They haven’t.  They’ve just accepted their mortality and launched a city-wide campaign to plan for the inevitable.  Doctors and patients together have removed the death taboo and sent it sailing down the Mississippi so they can get on with living. 

This idea certainly was not generated in La Crosse.  It’s About How You LIVE has been an ongoing national community engagement campaign to encourage Americans to:

Learn about options for end-of-life services and care.
Implement plans to ensure wishes are honored.
Voice decisions to family, friends, and health care providers.
Engage in personal or community efforts to improve end-of-life care.

What happened in La Crosse began with one medical ethicist, Bud Hammes, at Gundersen Health Systems. Hammes was bothered by the suffering he saw in families who had to make difficult medical decisions for their incapacitated loved ones. Some had no idea what their loved ones wanted for themselves. Occasionally families could not reach a consensus on what actions to take.

Hammes began teaching nurses to start the conversation early with patients by asking a simple question, “If you reach a point where treatments will extend your life by a few months and side effects are pretty serious, would you want doctors to stop, or continue to do all that could be done?”  Most said “Stop”. By completing an Advanced Directive, their wishes were documented and shared with family members and healthcare providers.  Families were now spared the burden of making life or death decisions in a crisis situation. 

The results of this simple action have been far reaching for La Crosse.  Nationally, less than 30% of those who die have an Advanced Directive in place.  In the last few years, 96% of those who died in La Crosse had an Advanced Directive or similar document in place. People have discovered the value of planning and documenting their wishes. 
Since many people choose to put limits on the amount of high-cost, live-extending procedures they elect, La Crosse has seen an unpredicted economic impact.  According the Dartmouth Health Atlas, the city of La Crosse spends less on end-of-life health care for patients than any other city in the nation.

Is Sheboygan ready to follow?  What will it take for our families to start talking about dying and end-of-life healthcare decisions, and then follow through with completing our own Advanced Directives? How much money can we save our city?  How much heartache can we spare our families?  Start the conversation.  Join the Conversation Project online at