Eunice Park-Clinton knows that preparing for future decisions about one’s medical care if they become seriously ill or unable to communicate their wishes isn’t a comfortable conversation topic for most people. Who wants to discuss the possibility of having dementia, getting hooked up to a ventilator, or being fed through a tube, and losing the ability to speak for oneself?
But Park-Clinton, a nurse case manager in the Hospital of the University of Pennsylvania’s Emergency Department and an assistant nursing professor at West Chester University, is undeterred.
As a Korean American, Park-Clinton’s passion for culturally sensitive planning comes from her personal familiarity with the community and its norms. In her work as a nurse, she has personally witnessed older Korean and other Asian immigrants experience health disparities due to their lack of knowledge of the concept. She was working in an intensive care unit, when an older Korean woman was admitted with pneumonia. The patient was being prepared to be intubated—in which a tube is placed into the airway to keep it open—and connected to a ventilator. That meant she couldn’t eat or drink anything by mouth.
Neither the patient nor her adult children spoke English well. Their pastor interpreted a doctor’s explanation of the advance care planning sheet to one of the patient’s daughters, and she signed it, but it was clear to Park-Clinton that the daughter didn’t fully understand what she had agreed to on her mother’s behalf.
“She was asking me, ‘Can you tell me what is going to happen? What is the ventilator?’” Park-Clinton says. Then, while she and the daughter were speaking in Korean, the patient asked for water. Park-Clinton explained in Korean that the patient couldn’t have anything to drink before being intubated, because the liquid could get into her lungs.
The patient died not long after. Months later, the daughter recognized Park-Clinton on the street and told the nurse she had been thinking about her mom’s last wish every day. “‘We could have just gone with water and food—what she wanted—without intubation,’” Park-Clinton remembers her saying. “And we started to cry on the street. At that moment, I decided, I’m going to continue my education and I’m going to teach all the Korean Americans about end-of-life care.”
During the seminars, funded with support from a Penn Medicine CAREs grant, Park-Clinton explains the importance of discussing one’s wishes with their loved ones and providers and designating surrogate decision-makers who can carry out those wishes on their behalf if needed.
Park-Clinton has found a more willing audience for her presentations since the COVID pandemic, as people are realizing that death may not be that remote in their life, she said. Taking an active role in their own care may alleviate their anxiety about what’s to come, knowing their values and wishes will be followed in a medical crisis.
This story is by Daphne Sashin. Read more at Penn Medicine News.
