TODAY | December 08, 2012
>>> when a loved one is faced with death, it can really feel like their dignity is also slowly being taken away. but when they're given more power over their death, one hospital in wisconsin finds those decisions can actually help people live. here's harry smith .
>> reporter: people come to the emergency room to have their lives saved.
>> resuscitation complete.
>> reporter: but as americans live longer and longer, the emergency room is not the best place to begin a conversation about how you want to live the rest of your life. or even how you want to die.
>> do you know where you are?
>> reporter: tough choices about which treatments and how much treatment become a guessing game , even powered by guilt. care specialist carrie low.
>> one family member may say we need to do this, we have to do everything. another family member that is saying we just have to make her comfortable.
>> reporter: but that rarely happens, in just what might be the best place to die in lacrosse, wisconsin, home to gunderson lutheran hospital. here 96% of the patients have a game plan for life and death . it's called an advanced directive. it starts with a very tough, very honest meeting they call "next steps."
>> tell me what you know about paul 's condition.
>> he's not going to get better. and we know that.
>> reporter: paul pearson has inoperable lung cancer . he and jeanne don't want there to be any doubt about how he wants to live out the rest of his life. so in this meeting run by jackie cartman, a nurse practitioner, paul and jeanne face their fears head-on. we were there to witness the process, which is as emotional as it is profound.
>> paul , what worries you about your illness? what fears do you have?
>> breathing is going to be a problem. and probably going into a nursing home . i don't want to be a burden to her.
>> reporter: paul is emphatic he doesn't want to linger or suffer and he is not afraid to say so by refusing treatment.
>> what i'm going to do now is read through these situations. if i have a serious complication from my cancer or treatment for my cancer so that i was facing a prolonged hospital stay and my chance of living through the complication was low, for example, only five out of 100 patients would live.
>> i would deny treatment.
>> it was expected that i would never know who i was or who i was with.
>> same thing.
>> reporter: one. the things they've learned here is all this talking about how you want to die, in many cases, helps people live longer and incredibly enough, costs less. at gunderson, patients in the last six months of life spend half as many days in the hospital as the national average. how helpful is it to have these conversations, to go through the scenarios ahead of time?
>> this gives us that advantage that we don't have to be second guessing. what should i do? we've already made those decisions. and they're hard decisions. but we're okay with them.
>> reporter: for "today," harry smith .