One of the most difficult situations to have is discussing end of life conversations. End of life discussions concern making an “advanced directive” outlining how people want to die.

Some 96 percent of people who die in La Crosse, Wisconsin, have an advance directive or similar documentation. Nationally, only about 30 percent of adults have a document like that.

La Crosse’s success at implementing such a difficult widespread behavior change is a great example of the principles of altering the situation with nudges. The La Crosse medical community proactively incorporates end-of-life discussions in every comprehensively across many patient interactions with hospital nurses in a multitude of situations. Essentially, members of La Crosse as patients are unable to escape the medical hospital being an open resource to be “trusted advisors” to start end of life discussions. By sprinkling “nudges” across numerous interactions with medical staff, La Crosse maximizes the chances that patients will say start the discussion instead of postponing it indefinitely.

Since 25% of medical costs is spent in the last year of life, La Crosse’s efforts have led it spend less on health care for patients at the end of life than any other place in the country, according to the Dartmouth Health Atlas.

Article Synopsis: http://www.npr.org/blogs/money/2014/03/05/286126451/living-wills-are-the-talk-of-the-town-in-la-crosse-wis

Full Podcast:http://www.npr.org/blogs/money/2014/02/28/283444163/episode-521-the-town-that-loves-death