Learn how one woman managed to change resuscitation protocols for emergency responders to decrease the incidence of unwanted CPR.
My guest Fran Myers is a healthcare consultant and the founder of the Center for Advance Care Planning. She will share how she investigated protocols for CPR that guide EMS first responders and discovered that they didn’t align with the statutes of the state of Colorado. Her success in changing the protocols is a story that will hopefully inspire people in other states to take up the same work to ensure that patients receive the care they want at the end of life. Read more about Fran’s work at her website:
What the public misperceives about CPR and where that mistaken idea comes from
Many people still receive unwanted CPR at the time of death in hospitals and nursing homes
Why paperwork is often disregarded by first responders in the field during a medical crisis
How EMS protocols foster the provision of CPR as a default treatment regardless of the wishes of patients and family members
How Fran went about getting the protocols changed in Colorado to allow first responders to withhold CPR when appropriate
Advice for people in other states who want to change the protocols in their area
How to access the Advance Directive Portfolio for your state of residence
We never say much as we frantically try to save the life we know we can’t save or perhaps silently hope we don’t save. When it’s finally over and the last heart beat blips across the screen and we survey the clutter of bloody gloves, wrappers, masks and needles that now litter the room, you may catch a glimpse as we bow our heads in shame, fearful perhaps that someday we may have to stand in front of God as he looks down upon us and says, “what in the hell were you thinking?” – Dr. Louis Profeta – Emergency Room Physician
Learn how planning ahead and being ready for the unexpected can be a special gift for your loved ones this year.
During the holidays we all want to find the perfect gift for our family members that will show them our love and bring joy to their lives. But face it … in this age of consumerism most people already have more possessions than they need and we have sadly littered our planet with excessive material goods that no one wants or can use. Here’s an idea for a gift you can give now that will bring peace of mind and relief to your loved ones some day in the future: plan ahead for the end of your life, gather your most important documents, and have a conversation with the people closest to you about your wishes.
Creating an end-of-life file that contains all of your most important documents along with your wishes for healthcare and after-death care is a task that will benefit you as well as your loved ones in the future. You will be saving them from a great deal of stress and frustration if they won’t have to search for your papers or guess what you might want for yourself when you reach the end of life. Why not use the holiday season as a motivator to complete your file and offer as a gift of love to your family!
This episode includes:
Ideas for storing your documents
Why it’s important to gather important information in one place so your loved ones can find it
Why you need to complete your advance directive (or living will) and choose a healthcare proxy now rather than later
The benefits of planning your funeral and burial in advance
How to view end-of-life planning as a gift of love for those who care about you
In this episode I share my thoughts on how to approach the very difficult task of making an end-of-life decision about the treatment a loved one should receive. Many people are called upon to be decision-makers in these challenging situations and this episode serves as a guide for choosing the best option for someone we love.Download the handout below:
This episode is sponsored by Suzanne O’Brien and her training program for caring for others at the end of life at Doulagivers.com and by your generous donations on my page at Patreon.com/eolu! Join the team and receive special bonuses as a thank-you!
Thank you to all of my patrons and sponsors! Your support means everything to me!
Every day families are called upon to make nearly impossible decisions about the type of care a loved one should receive as they near the end of life. Here are some suggestions for how to navigate this challenging situation when there is no advance directive available for guidance:
Gather medical information from all healthcare providers involved in care
Ask direct questions:
What is the diagnosis and what complications have occurred?
What is the effectiveness of the recommended treatment?
What are the chances for recovery or improvement?
Are there side effects from the treatment or will it cause additional suffering?
What will happen if treatment is stopped?
What would you do if this were your loved one?
Get expert advice and guidance from a palliative care team if available in your hospital
Remember past conversations with your loved one that might give you clues as to his or her preferences for the end of life
Consider the statistics that most Americans prefer to die at home and most do not want aggressive treatment to prolong life in the face of an incurable condition
Ask your loved one for guidance by expressing your concern and your desire to make the best decision. Even though your loved one cannot verbalize, they can hear you – listen for any intuitive or “felt” guidance that might come to you about the best choice to make.
Be gentle with yourself and recognize that you have done your best in a challenging situation
Seek support from others outside your family
Tune in next week for another episode! Share this content with others who might it helpful and consider leaving a review on iTunes.
Learn how to leave a written legacy for your loved ones and enjoy a retreat in Mexico in the process!
In this episode I share a conversation with Michelle Pante and Reena Lazar of Willow, a company that helps people express their personal and healthcare wishes for the future and leave a legacy of the heart for the ones they love. They will share their stories and tell us about an innovative retreat to Mexico they are planning this year – just in time for Dia de los Muertos!
You can still join our online reading group A Year of Reading Dangerously if you’re interested in reading a book each month about death, dying and the afterlife. Register here if you want to receive email notifications each month about the latest book selection. Go here to see the entire book list for 2018.
Thanks as always to my supporters on Patreon.com/eolu! Your monthly donations help keep this podcast and the EOLU interview series on the air. This week my thanks goes out to Suzanne O’Brien and Doulagivers.com for their ongoing support over the past year-and-a-half. If you’d like to join our team sign up at Patreon.com/eolu and receive special bonuses.
Today my guests Michelle Pante and Reena Lazar tell us how they started their company Willow and the services they provide to their clients. We talk about:
How the two of them decided to team up and create a vision together
How Reena uses her conflict resolution training in the work she does now helping people with end-of-life planning
Why they chose the name Willow for their company
What are “love letters” and “heart wills” and why they encourage people to create them
Tips for writing your own heart will
Details of the upcoming retreat in Mexico that includes a celebration of the Day of the Dead (you can still get the “early bird” discount of $200 off the price of the retreat if you sign up by August 20th and use the code EOLU)
Learn how answering just one question can simplify your decision-making process for end-of-life planning.
In this episode I’ll share how one simple question helped clarify my Mom’s end-of-life wishes and why I recommend starting there to put your own advance care planning into the proper perspective. This episode is sponsored by my course “Step-by-Step Roadmap for End-of-Life Planning.“
You can still join my online reading group for 2018 “A Year of Reading Dangerously” and read a book each month on death, dying and the afterlife. Sign up here.
Thank you to all of my supporters on Patreon.com/eolu! Your donations mean a lot to me!
Putting our wishes for the end of life into writing is more complicated than it seems. We can easily get lost when we start to consider all of the options available and make decisions about what we do or do not want for care during out last days.
When my mother was trying to complete her living we finally found a simple way to clarify what really mattered to her. I asked her to tell me how she wanted it to be when she was taking her last breaths in this life. And she answered right away: “I want to be in my own home with you taking care of me.”
That one question changed everything for us and her answer guided all of the decisions that we made together as a family for the next five years before her death. I have spent time thinking about the one question myself and it is clear to me that the only thing that will really matter to me when I am ready to die is love. I will want to be as near as possible to the people I love.
You can use this one question too:
Imagine your last moments of life: how do you want it to be?
Describe what you see in positive terms first: Who is with you? Where are you?
Keep it simple to avoid being overwhelmed. Just a few details are all you need to describe.
Finally add your 2-3 absolute DO-NOT’s to the picture. What do you definitely NOT want to have happen during your last moments? Again – limit the number to those things you feel strongest about. Your family will remember 2-3 requests but not 10-12.
Start talking now about your positive vision for your final moments and let your family know what you envision. When you engage them in your vision they are more likely to help you create it. They will have had time to think about your vision and to imagine themselves being part of it.
No matter what start thinking about the end of life now. It’s never too soon to get your plans in order! Consider signing up for the Step-by-Step Roadmap for End-of-Life Planning if you’d like to have a doctor by your side as you make decisions for yourself!
Learn about Molly’s innovative workshops on end-of-life planning that utilize art projects to inspire deep conversations.
In this episode I share an interview with Molly Stuart who is a lawyer, artist, chaplain and hospice volunteer. She teaches a wonderful workshop on end-of-life planning that includes art to help people uncover their deepest values and concerns.
Watch this episode on YouTube to view Molly’s slides:
The month of April features National Healthcare Decisions Day and in honor of that event I am sharing the 10-day S.M.A.R.T. Decisions Challenge – a free challenge that will help you get your end-of-life planning done with guidance along the way by email.
You can still sign up for A Year of Reading Dangerously if you’d like to read one book a month with us about death and dying! Sign up here.
Get the Teaching Guidelines for a Death & Dying Class and you’ll be on the list to hear about upcoming Work Groups and a Mastermind Group for Death and Dying Class teachers. Download the guidelines here.
Thank you to my latest supporter on Patreon.com/eolu: Kathy Lynch and thanks also to Cathy Duke for increasing your pledge! I’m so grateful for your contributions!
My guest Molly Stuart shares information about her innovative end-of-life planning workshops. We discuss:
How she got interested in teaching about end of life issues
The complicated nature of advance care planning
The 3-part workshop she designed, which includes:
Practical end-of-life medical and legal issues
Emotional aspects of living while knowing you’re going to die
Transformation and legacy
How Molly uses art to address:
The creative projects her students create as part of her workshops
How to create a legacy art project after the death of a loved one
Remember to tune in every Monday for a new episode and if you enjoy this content please subscribe and leave a review on iTunes!
Learn why the Death Education movement is vitally important right now for our society and get inspired to teach your own class about death and dying!
This week I’m continuing my focus on death education by discussing some important reasons why right now we desperately need more death-ed in every aspect of our society. Learn how you might become a death educator in your own community and start to share your knowledge to help others become aware of death.
You can still join A Year of Reading Dangerously and start reading books about death and dying with 700 other people around the globe! You’ll get to take part in live Q&A discussions with the authors of many of the books we are reading. For February we are reading Smoke Gets in Your Eyes by Caitlin Doughty–and she’ll be joining our discussion at the end of the month! Sign up now by clicking here!
Thanks again to all of my supporters at Patreon.com/eolu! Your generosity and encouragement mean everything to me! Become a patron for as little as $1 per month–where else can you do so much good with just $1? Go to Patreon.com/eolu to learn more.
Today I’m discussing why we need death education everywhere in our society and here are some of the places where it should take place:
Home – parents need to learn how to talk about death and dying with their children rather than shielding them from the reality of death
Schools – high school and college classes are a perfect place to introduce death and dying to young, curious students who can only benefit from learning more about death. (Next week I’ll share an interview on this podcast with Stacy Smith who teaches The Psychology of Death & Dying to college students, and on EOLU at the end of February I’ll present an interview about a high school elective on Death and the Meaning of Life with the teacher and 3 of his students.
Churches – clergy of all faiths need to be educated about death and dying so that they can better support their congregants on end-of-life issues within their belief system
Workplaces – employers need to understand the impact of death and grief on their employees in order to create supportive policies for bereavement leave; workers need to know how to interact with co-workers who are suffering with illness and grief
Medical system – doctors, nurses, and all other providers of healthcare need education in how to get comfortable with death, talk about it with patients and families, guide decision-making, initiate conversations with patients
Hospitals and nursing homes – need education to create sacred spaces for dying, to support patients and families at the end of life and honor patients’ wishes
Some of the reasons why death education is so important right now are:
We are living longer and the incidence of complex diseases like Alzheimer’s is increasing which creates a need for better advance planning. Patients and families need to prepare for the type of medical care and caregiving that may become necessary and understand how they can provide for those possibilities in the future.
Medical technology continues to advance at a rapid rate. Our ability to forestall death and keep a body alive has far outstripped our willingness to grapple with difficult end-of-life decisions. We need education to help people plan and prepare for the future and be pro-active about the care they receive. Studies show that those who think and talk about death are more likely to put their wishes in writing, to talk with others about their wishes, and to stop medical treatment when it is no longer helping.
Ethical and moral dilemmas about end-of-life issuesare splitting our society and families. Debates over physician-assisted dying and discontinuing medical care when it is not helping are going to increase with the aging of the Baby Boom generation. According to Pew Research Center surveys: 47% of Americans favor assisted-dying laws and 49% are opposed; 66% believe that there are times when doctors should stop treatment and allow patients to die a natural death, but 31% believe that doctors should always do everything possible to prolong life. These opposing perspectives are likely to be present in families too, especially if no advance planning has been done.
The high cost of being unprepared for death. Lack of advance care planning can lead to higher medical expenses, especially if the patient receive extreme care that was not actually warranted or wanted. Families unprepared for funeral planning are more likely to choose higher cost options and be vulnerable to unscrupulous marketing practices when they are grieving. Failure to plan ahead and put wishes in writing can cause increased stress and guilt for family members who must make decisions without any guidance.
The emotional and spiritual cost of ignoring death. As described in episode 127, death is our greatest teacher about life. Those who fail to recognize the inevitability of death are less likely to live to the fullest and appreciate the moment because they think they have plenty of time.
If you care about any of these issues and have been learning about death and dying by listening to this podcast and the End-of-Life University Interview Series, you are the perfect person to become a “death educator.” Start by sharing what you’ve learned with family and friends and consider putting together your own class in your community to help educate others.
You can download my free pdf: Teaching Guidelines for a Death & Dying Class and get some tips and tactics for starting your own community death-ed class! When you download the handout you’ll receive an invitation to a special work group I’m putting together in March on brainstorming your class.
Stay tuned to future episodes of this podcast to get more information about death education: next week I’ll share an interview with Stacy Smith about teaching college students about death and dying. On February 22nd I’ll present an interview on End-of-Life University with the teacher and students from a high school death-ed elective.
I hope you feel inspired to become a “death educator” in whatever capacity suits you, whether you simply share your knowledge with family and friends or start a class in your community!
If you enjoy this podcast please consider leaving a review on iTunes – it will be greatly appreciated!
Learn some steps you can take NOW to ensure that you will be at peace when you reach the end of life.
This week I’m sharing with you my reflections on what it takes to be at peace when you die. I just observed the 5th anniversary of my Mom’s death and I was inspired to create this podcast by thinking about the peace she experienced at the time of her death and how she was able to achieve that!
Thanks to my latest supporter on Patreon.com/eolu: Cheryl Durden! Your contribution to this podcast and to the End-of-Life University Interview Series is greatly appreciated!
After writing a blog this week called “Why Some People Don’t Die in Peace” I decided that I should go further and address HOW to actually be more at peace when the end of life arrives. So here are my thoughts! These are all things to start working on now in order to be at peace in the end:
Plan ahead for your time of dying: What type of care do you want to receive? Where do you want to be when you die?
Hear my far-reaching dreams and ideas for changing the way people die in the U.S. in 2018.
In this episode I talk about some of my own personal goals for the New Year and then discuss a list of ideas for ways in which we need to improve all aspects of the end of life. Get some inspiration for steps you can take within your own community and in your own personal life to “Be Good at Death.”
I’ve started a new year-long reading group called A Year of Reading Dangerously for 2018! We’ll be exploring death and the afterlife through books that hopefully will inspire us and stretch our boundaries. Sign up to receive a monthly email with the book selection for the month and a downloadable reader’s discussion guide. Join the fun!
A HUGE thank-you to my latest supporters: Claire Turner and Dr. Leslie Robinson. Your contribution is greatly appreciated as it helps defray the costs of producing and broadcasting this podcast and the End-of-Life University Interview Series, but it also provides me with much-needed emotional and spiritual support! To donate as little as $1 per month go to Patreon.com/eolu.
There is a new pledge level on Patreon-the Platinum level-where for a donation of $5 per month you’ll receive replays of ALL of the End-of-Life University Interviews for 2018. So check it out now!
What we need to do to “Be Good at Death” in 2018″:
Policy Level changes needed:
Improve reimbursement for Palliative Care
Stabilize and improve reimbursement for Hospice Care
Establish a system for paying family caregivers
Medical System changes needed
Integrate Palliative Care into Primary Care and therefore …
Increase home-based palliative services
Rank hospitals according to the quality of end-of-life care provided (based on an article by Dr. Haider Warraich from Duke University). Dr. Warraich’s criteria for this ranking include:
“percentage of patients with a documented health care proxy
percentage of patients who receive heroic measures like cardiopulmonary resuscitation or cardiac defibrillation
appropriate use of hospice and palliative care
the likelihood of a family recommending the hospital for end-of-life care
whether patients’ location of death was concordant with the place in which they had wanted to die
availability of around-the-clock spiritual resources
the training the medical team receives for dealing with the medical and psychosocial issues that arise when death is imminent” ((Thank you Dr. Warraich for this fabulous idea!))
Medical Education changes needed
Train all medical providers in palliative care (at least a one-month rotation) regardless of specialty
All medical students work with dying patients in at least one rotation
Teach better conversational and listening skills to medical providers
Help medical providers process their own fears and biases toward death and their repressed grief
Learn how to awaken to higher consciousness NOW so that you can experience conscious dying at the end of your life.
In this episode I share the secret behind the 3-part tagline I use on the EOL University website and at the end of every podcast. (If you listen regularly you’ll know exactly what I’m talking about!) I discuss the wisdom behind the phrases I repeat each week and how they represent keys to our ongoing spiritual evolution!
My long-awaited trip to Italy begins tomorrow, the day after the original airing of this podcast! You can follow my journey on Instagramand Facebook as I hike, bike, eat, drink, pray, and write my way through the country–all in search of the perfect stories for my new book on grief! I’ve pre-recorded enough podcast episodes to last until I return in one month–“see” you then!
I would like to send a HUGE THANK YOU to my latest supporter on Patreon.com/eolu: Rich Hayes, who is a hospice chaplain. Check out his website at www.richhayes.com and his book God Made Simple. If you would like to join the list of patrons go to Patreon.com/eolu to learn more and chip in $1 or $2 per month to support this podcast and the EOLU Interview Series. You’ll receive a thank-you on this podcast and I’ll also promote your end-of-life related book, website, cause or business. PLUS you’ll receive the monthly Hospice Happy Hour Q&A recordings!
3 Keys to Living & Dying Consciously
(Be sure to tune in to upcoming podcast episode #112 when I will feature an interview with philosopher and sage Ken Wilber about conscious dying and the death of his wife Treya. If you are interested in conscious dying you won’t want to miss it!)
In order to die consciously you must first begin to LIVE consciously right now. Here are my 3 tips for awakening to higher consciousness–they have been hiding all along in the simple tagline I use at the end of every podcast! Now you’ll find out what I mean when I remind you of them every week!
Face Your Fear
You must go through your fear in order to rise above it; the more you hide and run away from your fear of death (which is the ultimate fear) you run away from joy, as well. So begin to accept that Death is inevitable–everything in the Universe dies–and life is full of difficulties. Once you embrace that fact you can begin to work specifically on your fear of death and turn it into acceptance.
Think about death every day. Include contemplation of death as part of your daily practice; get used to the idea that life is fleeting and you don’t know when it will come to an end.
Read about death. Find books (e.g. What Really Matters) and stories that portray death and dying in a meaningful way to help you see that it is not necessarily something to fear. The dying process can be a beautiful time of healing for patients and families.
Write about death. Use your journal to record your thoughts and emotions about death. Observe how they change over time as you continue this practice of increasing death-awareness. (The book The Tao of Death with its companion journal can be a helpful tool for reading and writing about death.)
Learn about death. The more information you have about the end of life, the more your fears will lessen. Knowledge is one of the most powerful antidotes to fear. Tune in to the interviews on End-of-Life University for an ongoing education about all aspects of the end of life.
Work with death. Consider volunteering for hospice to learn how to sit with death and witness the dying process. Hospitals and nursing homes are also good places to volunteer to get closer to death and overcome your fear.
There is no substitute for preparation, no matter what you might face in the future. Once your fear has decreased begin to plan ahead for the end of life and imagine how you would like that experience to unfold. Here are some steps to help you get ready:
Know what really matters to you. Spend some time thinking about what in your life is most important and prioritize those items. You need to know what you value in order to make tough decisions in the future.
Make choices for what you want at the end of life. Use a tool like the Conversation Project Starter Kit to help you decide what type of healthcare you would like to receive in your last days.
Complete your paperwork. You need to appoint a healthcare proxy and fill out an advance directive form in order to give your wishes some legal clout. But you also need to talk to your loved ones and your doctors about your wishes so they will know how to care for you if you can’t speak for yourself.
Tend to your relationships. Learn how to forgive NOW so that you won’t be rushing to complete this important task while on your deathbed. Remember to say “I love you” to those who matter to you whenever you have an opportunity.
Learn to BE in the present moment. Let go of ruminating about the past and worrying about the future–love and joy exist right here, right now in this present moment.
Love Your Life
Once you have learned to manage fear and to BE ready for anything that comes your way, you can begin to learn to love your life just as it is, even if you are surrounded by tragedy and pain. Here are some steps to consider:
Live according to what really matters to you. Let you values guide your choices each day and put your time and energy into the things that are most important.
Practice gratitude each day. Keep a journal and begin by writing down one thing you are grateful for each night before you go to sleep. Even in the worst of times you will be able to think of one thing to be thankful for–you just have to shift your mindset to a more positive focus.
Learn to find love in every situation. After you have developed a gratitude practice you will begin to notice that love is actually present everywhere, in everything that happens. Start focusing on the love and you will find it more and more frequently.
Allow love to fill you. You can become a channel for love to the rest of the world by simply letting love into your life in every possible way. Fill yourself with love so you can share it with others.
Life is an ongoing learning process! No lesson comes easily or without a certain amount of pain, but it’s worth it. If you begin conscious now and begin to live a life of love, then you will remain conscious when it becomes your time to die. You will continue to radiate beauty and joy to those around you–I’ve seen it happen over and over again!
Here are two books to help your learning process and your practice of death awareness:
Learn how to make the best choice for an advocate for your end-of-life wishes.
In this episode I discuss the importance of choosing the right person to be your healthcare advocate. This might be the most important decision you will make regarding your end-of-life wishes, so choose wisely!
Learn the myths and facts about Cardiopulmonary Resuscitation.
In this episode I’ll discuss the misunderstandings that exist in our society about CPR, primarily due to the way it is portrayed in movies and on television programs, like House and ER. It’s important to know the truth about CPR in order to make the best decisions for our future healthcare.
Be sure to sign up for “An Evening with Ira Byock, MD” on August 21st. Help us celebrate the 20th Anniversary of his book Dying Well. You’ll receive the replay if you can’t attend live.
You can help support this podcast by making a small donation ($1 or $2 per month) at Patreon.com/eolu. Thank you to my latest contributors Karen Greer and Barbara Richardson. I really appreciate your support and it helps me keep the podcast and the End-of-Life University Interview Series on the air! Check out Patreon.com/eolu.
This is a follow-up to the latest interview on EOL University Interview Series with Dr. Fred Mirarchi, and ER physician who has conducted the TRIAD Studies (The Realistic Interpretation of Advance Directives.) In that presentation Dr. Mirarchi shared how advance directives like Living Wills and POLST forms are often misinterpreted by healthcare providers, resulting in patients receiving less or more intervention than they specified in their paperwork. You can listen to Dr. Mirarchi’s talk here.
three myths about CPR that are commonly believed
the true statistics about the outcome of CPR
the difference between CPR and the use of AED’s (automated external defibrillator)
when CPR might be called for and when it is likely to cause more harm than good
issues to consider when completing your CPR or DNR directive
You can download the handout “Facts About CPR” from the Colorado Advance Directives Consortium by clicking below:
Find out how The Conversation Project is helping families talk about planning ahead for the end of life.
In this episode we’ll hear about the work of The Conversation Project from an advisor to the organization, ICU physician Dr. Jessica McCannon. Learn how to utilize this excellent tool to get your own conversations started.
COLORADO LISTENERS!! You can download a special version of The Conversation Starter Kit that has been customized just for Coloradans. This version is a little shorter and includes a place where you can name your Medical Durable Power of Attorney. Visit this website to download your copy now:
You can still sign up for the Death & Afterlife Summit, which takes place March 16-18, 2017. You’ll be able to learn from 10 experts about dying, death and beyond in this series of online interviews–and it’s totally FREE! Go to eoluniversity.com/afterlife to learn more and register.
If you’d like some guidance in completing your own advance directives, check out the Step-by-Step Roadmap to End-of-Life Planning–my NEW online self-directed course that will help you prepare and plan for your later years.
The Huntsville Hospital in Huntsville AL has started a unique pilot program that places a hospice nurse in the Emergency Department 3 days a week. The RN meets with patients and families and educates them about end-of-life options to help in their decision-making processes. She also helps them complete advance directives and other documents needed for their hospitalization.
THE CONVERSATION PROJECT:
Join Dr. Karen Wyatt and her special guest Dr. Jessica McCannon, ICU physician and advisor to The Conversation Project, a non-profit organization dedicated to helping people talk about their wishes for end-of-life care. They will discuss The Conversation Project, the history and goals of this organization, and how their resources can benefit you, your loved ones or your patients when making plans for the end-of-life.
You will learn:
How and why The Conversation Project was started
The value of telling stories about the end-of-life
Benefits of The Conversation Starter Kit and The Pediatric Starter Kit
How doctors might utilize The Conversation Starter Kit
Dr. Jessica McCannon is board-certified in internal medicine, and completed Harvard’s Clinical and Research Fellowship in Pulmonary and Critical Care Medicine. After completing her internal medicine residency training at Massachusetts General Hospital, she began providing care to adults at the Mass General Hospital Down Syndrome Program. Prior to starting medical training she received her BA from Cornell University. Dr. McCannon currently practices clinical medicine as an ICU physician and serves as an advisor to The Conversation Project.
Tune in each Monday for a new episode. If you are interested in supporting the podcast and the End-of-Life University Interview Series you can make a small contribution of just $1 or $2 a month and help keep us on the air! Go to Patreon.com/eolu to learn more!
It’s not enough to get your paperwork done … make sure it’s done right!
In this episode we’ll look at several common mistakes people make when doing their advance directives–mistakes that could make it more difficult for their end-of-life wishes to be carried out. Learn how to get your paperwork right so you can relax!
This podcast is supported through the generous donations of listeners made on Patreon.com/eolu. When you donate just $1 or $2 per month I will thank you by mentioning your name on the podcast and promoting your cause!
Thank you to my latest patron: Jayne Boulton–I appreciate your support Jayne!
In the News:
An online article from Managed Healthcare Executive asks the question: Can Data Analytics Aid in End-of-Life Care Decisions? The author cites a recent study from JAMA that shows 70% of MD’s reporting that they have not been trained to have end-of-life conversations with patients and 73% of patients over the age of 65 have never had an advance care planning discussion with a doctor.
Medical data analysts have suggested that EHR’s might be useful to help health systems identify patients in need of end-of-life conversations. The article points out that current management of advance directives on EHR’s is poor since on average it requires clicks on 12 different screens to locate a patient’s AD, which takes 1.3 minutes–not fast enough in an emergency situation. In addition many patients at the end of life experience more than 3 transfers to different facilities and their paperwork is often lost in the process.
Much work needs to be done to help patients get their wishes met at the end of life! For that reason I have created a NEW online course to guide people through creating their advance directives, making them legal, and having conversations with loved ones and doctors about their wishes.
What does it take to have a smile on your face the day you die?
In this episode I pay a tribute to my Mom, Margaret Wyatt, who died 4 years ago in her own home, filled with joy and love. I’ll share the lessons I learned from her death about how each one of us can “Die Happy”!
This podcast is sponsored through the EOLU donation page at Patreon.com/eolu. By contributing just $1 or $2 per month you can help support the podcast and the End-of-Life University Interview Series. If you become a supporter I will happily promote your book, website, cause or organization on a future episode of the podcast!
Michelle Holmes – who has asked that I promote a favorite cause of hers: The Still Place.The Still Place is a charitable organization providing rest, renewal and re-creation to families living with serious illness in hope of fostering resiliency, empowerment and self-determination. We provide free of charge vacations, uniquely planned and lovingly facilitated for families who find it difficult if not impossible to get away, plan and experience the healing restorative properties of a family vacation. Go to their website at www.thestillplace.org to learn more!
Holly Pruett – who is the founder of Death Talk Project. Death Talk Project organizes workshops, rituals, Death Cafes, monthly movie nights, and other events in Portland, Oregon. Join in for useful, honest conversation about how we die, how we mourn, and how we care for and remember our dead. Holly also created the community event Death OK: Let’s Talk About It and Death Talk Project grew out of that event. Learn more at www.deathtalkproject.com.
A Tribute to Margaret Wyatt
My Mom died four years today, on the day I am writing and recording this episode, and I had the privilege of being at her bedside for the last 5 days of her life. She was happy and joyful and filled with love as she took her final breaths and she inspired me to want to teach other people how to die happy too.
Mom was in very frail health for the last 5 years before she died and had become housebound as a result. She only left her home a handful of times during those years, but she received help from a friend with grocery shopping, housework and laundry.
Believing that she was going to die soon, Mom set about to plan and prepare for her own death, though she didn’t realize then that she would live for 5 more years. She created a Living Will (using Five Wishes), planned her funeral and burial (and paid for them), and gathered together all of the financial, insurance, and estate documents that she thought my brother and I might need after her death.
She also talked about her own death, her end-of-life wishes, and how she imagined her own dying process. She made sure that both my brother and I knew what she wanted at the time of her death: to be in her own home, in her own bed, with me at her side providing care. And that is exactly what happened when she died. Her wishes were fulfilled because she had thought about them, planned for them and talked about them.
Mom was happy when she died because she was ready to go. She wasn’t afraid to die and felt that she had lived a full life. There was nothing left undone in her mind and she was looking forward to leaving her tired and painful body behind when the time came. Her death was happy, peaceful and beautiful because of the way she lived her life. Here are some of the lessons I learned from her about how to die happy:
Believe in something bigger than yourself. Mom always devoted her time to being of service to others. In her last years of life she spent every afternoon praying for people from the comfort of her reclining chair.
Have a daily spiritual practice.
Prepare for and talk about death. As already mentioned, Mom was ready in every possible way for her own death.
Let go of attachments. She freed herself from some of the burden of material possessions by giving things away to her visitors for 5 years.
Make amends with the past and with other people.
Be satisfied with life just as it is.
Make the most of whatever you have been given.
My Mom is dearly missed but I am comforted by knowing that she was happy when she died. Her beautiful death inspired all of the work I have done in the past 4 years with End-of-Life University, Death Expo and this podcast. I’m passionate about helping everyone find a way to die happy! I wish you could have met her ….
It’s a brand new year! Let’s look ahead and see what’s possible in 2017!
In today’s episode of the podcast we’ll look ahead at the coming year, study the trends in the death-positive movement and discover where it might be possible to create new volunteer and career opportunities for ourselves and our communities in 2017.
First I’ll share my own goals for the coming year, which include revising, editing and publishing the two books I wrote in 2016. I also plan to release two new training courses this spring and have lined up a fascinating group of speakers for the End-of-Life University Interview Series. To stay up-to-date on all the latest interviews and offering from EOLU, be sure to to sign up for the mailing list here.
Thank you from the bottom of my heart to all the contributors to this podcast on Patreon.com/eolu. Your support helps pay for the expenses of creating this podcast and the EOLU Interview Series. If you’d like to become a patron just go to Patreon.com/eoluand sign up to contribute just $1 or $2 per month.
Here are some of the Trends I’ll be watching in 2017:
Increasing number of Palliative Care Programs in hospitals across the country. Though many of the current programs are either understaffed or underfunded, these problems are likely to be corrected in the near future. To meet current standards, each palliative care team must have a chaplain and a social worker so if you have training in either of those fields you might find employment opportunities in a palliative care program in your community.
Need for creative solutions for hospice care. Because for-profit hospices are taking over many of the smaller non-profit hospices there is a risk that uninsured patients or those with needs for expensive care might be turned away. There is a need for social-model hospices (see Episode 23) and possibly for community-based non-profit, non-Medicare-certified organizations that can help bridge gaps in services for hospice patients. Here are some recommended training programs for becoming an end-of-life doula or midwife:
Need for more caregivers. As baby boomers age and approach the end-of-life the caregiver shortage will become a much greater issue. Opportunities will exist to create caregiver training and support services in communities and even to start businesses that employ caregivers.
Community outreach can help support the changes that are slowly occurring in the healthcare system. One of the best ways to encourage change in healthcare is to empower consumers to demand changes from their physicians. This will require outreach and education in the community. Here are some ideas for outreach and links to learn more from previous podcasts:
Create an “Inreach” for members of the EOL community by starting a discussion group, networking event or collaboration opportunity for those who are already working in this arena.
Bring volunteer movements to your community. Consider starting a group of volunteer caregivers who can provide respite care for family caregivers or start your own chapter of Threshold Choir, Twilight Brigade, or No One Dies Alone.
Provide education for your community either as a voluntary act of service or as a paid instructor. Here are some possible ideas:
Assist people to correctly complete their advance directives.
Teach a community class on death and dying.
Teach about green burial, promote a natural burial ground in your community, help people access green burial supplies
I hope these ideas inspire your own personal goals for 2017! Stay connected with me and keep tuning in to the podcast. Let me know your own inspirations and plans for the New Year by adding your comments.
In this episode Dr. Wyatt thanks her latest supporter on Patreon.com/eolu, Suzanne O’Brien RN, founder of Doulagivers. If you would like to help support this podcast and End-of-Life University Interview Series for the small contribution of $1 or $2 per month, go to Patreon.com/eolu and sign up to become a supporter!
In other personal news, Dr. Wyatt just reached the 50,000 word goal on her novel-writing challenge for the month of November! Stay tuned for more information on Starry Night, a novel about living and dying!
Go to DeathExpo.com if you are interested in getting the downloadable filed from Death Expo 2016. Tune in to Episode 65 to hear the highlights and take-aways from this fantastic educational event!
Next Dr. Wyatt shares the latest news and information about end-of-life issues that caught her eye during the month of November:
Survey of seniors in the U.S. shows that 27% have done absolutely no planning or preparing for the end of life. Those least likely to have prepared correlate with the following characteristics: age between 65-74, black or Hispanic, low-income, low education level, and diagnosis of Alzheimers.
Canadian study shows that for seniors who have completed Advance Directives, Values and Choices do not always align, showing a lack of guidance for choosing end-of-plans and confusion about basing choices on underlying values
a paper cited in the Journal of Pain and Symptom Management calls for improved consistency in honoring the EOL choices of patients in nursing homes and hospitals
Go Wish Card Game found helpful for patients completing their advance directives; helps them identify their values and priorities
Home-based Palliative Care shown to lower healthcare expenses in last year and 3 months of life, decrease hospital admissions and increase hospice utilizations. 87% of patients who receive palliative care at home are able to die at home, compared to only 24% of all Medicare patients who die at home
Review of 43 palliative care clinical studies shows that palliative care improves quality of life but does not extend life
UC Santa Cruz has started a program to pair pre-med students with hospice patients
Study shows doctors are reluctant to discontinue routine medications that are no longer indicated for their patients at the end of life due to lack of awareness, low priority, and fear of causing patient to feel abandoned
Colorado became 6th state in the U.S. to approved medically aided dying during the November election
AARP and the National Association of Area Agencies on Aging have a launched a campaign to identify seniors suffering with loneliness and isolation in order to connect them with community resources; 43% of seniors report loneliness which leads to medical consequences
new movie Collateral Beauty deals with grief and death and will be released on Dec. 16th
Canadian singer-songwriter Leonard Cohen died on November 7th at the age of 82
Join Dr. Karen Wyatt, the host of Death Expo, in this conversation with emeregency room physician Dr. Monica Williams-Murphy, author of the award-winning book It’s OK to Die. They will discuss Dr. Williams-Murphy’s mission “to create conditions in which people: plan ahead, make their peace, understand that it is OK to die naturally, and make educated choices which allow them to pass away peacefully and comfortably surrounded by those who love them most.”
In this interview you will learn:
the tragic consequences of being unprepared for the end-of-life
the factors that have contributed to our cultural change in attitude toward death and dying
how to prepare for the death of a loved one – understanding the physical changes associated with dying
how to make peace with death and let go at the end-of-life
what doctors need to know in order to offer better care at the end-of-life
Support this podcast and End-of-Life University Interview Series by donating at Patreon.com/eolu!
Dr. Wyatt thanks her newest Patreon.com supporter Tracy Zagata. You can become a supporter as well by going to Patreon.com/eolu and signing up!
Sign up for Death Expo which will take place Nov. 10-13, and hear 12 speakers on EOL issues. Go to DeathExpo.com to register free to tune in to these excellent presentations.
This episode is taking place on Halloween and the Day of the Dead. Dr. Wyatt includes the following updates:
CMS report 52% increase in Medicare spending on hospice between 2007 and 2015 due to 38% increase in the number of patients receiving hospice care, primarily patients with dementia
the DEA is mandating 34% decrease in opioid production due to dramatic increase in opioid-related deaths since 1999 – rate has quadrupled during that time frame
JAMA Oncology reports that the cost of secobarbital, the drug most frequently prescribed in assisted dying cases, has increased by $25oo; there is no explanation except that drug companies can get away with it
California is the first state to require that palliative care teams have a chaplain for those patients who want to receive spiritual care
Debra Beaulieu writes in HealthLeaders Media that all clinicians should know the following about palliative care: 1) that it’s not just for dying patients 2) that it is often underutilized and 3) all clinicians should have basic palliative care skills
Study in J. Palliative Med showed that home-based palliative care (as opposed to hospital-based care) meets more of patients’ needs in the last 3 months of life and costs $12,000 less per patient
Controversial “doll therapy” for dementia patients
Study shows that 11% of female caregivers over the age of 50 have to leave their employment to fulfill caregiver duties, costing $300,000 in lost wages, benefits, and Social Security over time
Census data reveals that currently 25% of seniors are considered “Elder Orphans,” meaning that they have no children or close family to care for them; these numbers will only grow as Baby Boomers age, reinforcing the need for more caregivers
Medicare Care Choice Pilot Program is currently underway; patients can receive home-hospice care while continuing curative treatments if they have a diagnosis of cancer, COPD, CHF, or HIV; there are 140 participating hospices in the program
Survey shows that 1/2 of MS patients would consider medically assisted dying in the case of unbearable pain, being a financial burden to others, or if unable to enjoy what makes life worth living
Study reveals the 69% of MOLST or POLST forms have incomplete information and 14% have conflicting choices, making them nearly impossible for care providers to follow
the nation’s first conference on VSED was held in October at the Seattle U. School of Law and was featured in an article in the NY Times. Phyllis Shacter was a speaker – you can hear her EOLU interview in episode 25
Conversation Sabbath will take place November 11-20 with >30 congregations from various faiths participating; the focus will be on EOL conversations and theconversationproject.org will provide tools and resources for the event
Andrew Henderson, 28 year old performance artist who is terminally ill has created an art performance called Taking it to the Grave and will tattoo the secrets of his audience on his body before he dies
Miss Norma, the 90 year old woman who chose to go on a cross-country RV tour with her son and daughter-in-law rather than undergo treatment for cancer, has died
Have a safe and meaningful Day of the Dead! Tune in every Monday for a new episode and support EOLU at Patreon.com/eolu. Until next week remember to:
Marggie Hatala – author and teacher of a writing class related to end of life; her books are “Sally: A Memoir” and the forthcoming “Life as Prayer”; learn more at www.marggiehatala.com
Next she begins the Update for September by talking about the new documentary film currently streaming on Neflix: Extremis, which won 1st place at the Tribeca Film Festival. Please see this film which takes place in the ICU at Highland Hospital in Oakland and features Dr. Jessica Nutik Zitter. This is a must-see film that brilliantly depicts the conundrum that exists at the end of life when painful decisions must be made. By showing the real-life conversations that take place in the ICU between staff, family members and patients, a case is made for everyone to complete their advance directives and prepare their loved ones to honor their wishes at the end of life. But the painful process of decision-making becomes apparent as each individual struggles with the unknown and the unknowable in these dire situations.
The other topics covered this month include:
BMJ Online report that patients who receive hospice care for the last 6 months of life have better pain control, fewer hospital days, and are less likely to die in the hospital or ICU.
Researchers at John Hopkins found that their palliative care program led to savings of ~ $19 million over 5 years in addition to improved quality of care and patient satisfaction.
Study originally published in Health Affairs and reported on Reuters online showed gaps in palliative care in the US. Read the article.
“What it feels like to die,” an article in The Atlantic discusses the active dying process from the patient’s perspective. Read the article.
Friends and Family Letter Project by Dr. VJ Periyakoil at Stanford includes 7 prompts for letter writers to leave messages for their loved ones. Read the article.
“7 Songs for a Long Life” documentary from Scotland that depicts how terminally ill patients use singing as therapy. Read the article.
The Friendly Atheist Julie Stahl reminds us not to impose our own religious or spiritual beliefs on those who are grieving and may not share your perspective. Read her blog.
Thanks for tuning in to the podcast! I hope you enjoy this information. If you feel inspired to offer a little support go to Patreon.com/eolu to join the community!