Ep. 109 Twenty Years of “Dying Well” – A Conversation with Ira Byock, MD

Learn from palliative care thought leader Dr. Ira Byock how end-of-life care has changed over the past 2 decades since his book “Dying Well” was published.

PodcastByock

IralaughingIn this episode I share a recent interview with Dr. Ira Byock that celebrates the 20th anniversary of his book Dying Well and features his wise perspective on end-of-life care “then and now.”

Learn more about Dr. Byock at www.irabyock.org.

Get Dying Well at Amazon or Barnes & Noble

ANNOUNCEMENTS:

OLYMPUS DIGITAL CAMERAAs you listen to this broadcast I am currently in Italy–traveling and doing research for my new book on grief (also eating … a lot!) This episode has been pre-recorded (along with several others) so that there will be no interruptions in the podcast. If you want to see photos of my journey follow me on Instagram or Facebook.

Patreonbecome2xThis podcast is generously sponsored by donations on my page at Patreon.com/eolu. Thank you to all of my patrons–your support means everything to me!! Submit your questions for the next “Hospice Happy Hour” Q&A Session here and I’ll answer them next month. You can become a patron for just $1 or $2 per month and you’ll receive access to the Q&A recordings, the Top 10 Interviews from EOLU, and the opportunity to have your work promoted on this podcast. Go to Patreon.com/eolu to learn more!

FEATURED PRESENTATION:

Read the transcript of this interview here:

EOLU17Byock

In this interview I will talk with Dr. Ira Byock about his groundbreaking book Dying Well: The Prospect for Growth at the End of Life which was published in 1997. We discuss:

  • How he first got interested in hospice care during his residency training
  • What inspired him to write Dying Well
  • How writing the book helped him heal his own grief over his father’s death
  • Changes he has seen in hospice and palliative care over the past 20 years (“the good, the bad, and the ugly”)
  • Where we should be focusing our efforts now to continue to improve the end of life for everyone
  • The upcoming Symposium on Palliative Care, Pain Management and Whole Person Care where Dr. Byock will be a presenter
  • Where to purchase Dying Well

Download the Readers Discussion Guide for Dying Well here.

Dr. Ira Byock is a leading palliative care physician, author, and public advocate for improving care through the end of life. He is the Founder and Chief Medical Officer for the Institute for Human Caring of Providence St. Joseph Health.

Tune in every Monday for a new episode of the podcast! If you enjoy this content please take a moment to leave a review on iTunes – it will help other listeners find the podcast.

Meanwhile remember ….

Face Your Fears.                       BE Ready.                      Love Your Life.

karen-signature

 

 

SaveSaveSaveSave

SaveSave

Ep. 76 What My Hospice Patients Wanted You to Know

What advice do hospice patients have about how we should live?

podcasthospice

 

 

In this episode I’ll share some of the wisdom I gathered from my hospice patients as they faced the end of life. This simple advice can help us live more fully with less fear and worry.

supportonpatreon-e1412764908776This 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!

Today I have a huge thank-you for my new patron on Patreon.com/eolu: Kerrie Noonan. Thank you for your support Kerrie!

In the News:

  1. An article on Time.com listed “7 New Jobs That Are So ‘2017’” and included Death Doula as one of the new occupations! What’s great about this is the fact that a major news outlet is breaking through the taboo and using the word “death” and that there has been a recognition of the importance of people who assist others at the end of life. In Episode 71 I listed Death Doula as one of the trends for the year and included links to several training programs for becoming a doula. If you are considering a career change or looking for some post-retirement work you might want to become a midwife for the dying. There will be a huge demand in the very near future for people fulfilling this role.
  2. In a story reported on the Today show we learned that 31-year-old actor Chris Salvatore invited his 89-year-old neighbor to live with him when she was no longer able to live on her own. Salvatore and Norma live in the same apartment building and had been friends for about 5 years when she was hospitalized with leukemia and respiratory problems. When doctors told Norma she would have to go to a long-term care facility because she had no family members to care for her, Chris stepped up and took her into his home. He now provides care for her as she faces the end of her life. Doctors didn’t expect Norma to live through the holidays but she is thriving in her new home. This example of selfless generosity is exactly what we need as we move into the future where 25% of Baby Boomers will have no family members available to provide care to them. Well done Chris Salvatore – a huge salute to you from End-of-Life University!

What My Hospice Patients Wanted You to Know:

Here is some of the wisdom my hospice patients shared with me as they neared the end of their lives. I promised them that I would bring their messages to you since they are no longer here to speak for themselves.

The spiritual lessons I learned have been compiled in the book What Really Matters: 7 Lessons for Living from the Stories of the Dying. The following tips are the additional pieces of advice they had for all of us:

(Read the full blog post here.)

  • “What seems important now doesn’t matter in the end.”
  • “Don’t worry so much about diet and exercise.”
  • “Your doctor doesn’t have all the answers for you.”
  • “Your life’s purpose isn’t what you think.”
  • “Religion is less important than learning how to love others.”
  • “Dying isn’t as scary as you think.”
  • “You’re going to die anyway so you might as well be ready.”

Listen to this episode so you can learn more about each of these statements. And then maybe you’ll be inspired to change some aspects of your life and prepare for the very end!

Be sure to subscribe to End-of-Life Interview Series (if you haven’t already) so you can listen to our fantastic educational interviews with EOL experts every month. Go to www.eoluniversity.com to register. And if you’d like to support EOLU and this podcast check out the donation page at Patreon.com/eolu.

Tune in next week for another new episode and until then remember:

Face Your Fears.                      BE Ready.                    Love Your Life.

karen-signature

Ep. 59 How to Avoid ‘Compassion Fatigue’ for Caregivers and End-of-Life Workers

This week Dr. Karen Wyatt addresses ‘compassion fatigue,’ which is an occupational hazard for those who care for others who are suffering emotionally or physically.

Death Expo is coming up November 10-13, 2016 and you can register by going to DeathExpo.com. There will be 12 speakers on various aspects of death, dying and bereavement, so be sure to sign up for this FREE virtual conference!

You can help support EOLU by going to Patreon.com/eolu and making a donation of $1 or $2 per month to help defray the expenses of creating the interview series and this podcast. Thank you to all of the current “Patrons” who are offering their support – it is much appreciated!

Today’s discussion centers around Compassion Fatigue and you will learn:

  • What is compassion fatigue
  • Who is susceptible to compassion fatigue
  • The signs and symptoms of compassion fatigue
  • Tips to prevent it:
    • Regular exercise
    • Adequate sleep
    • Healthy diet
    • Journaling
    • Deep breathing
    • Mindfulness meditation
    • Witnessing perspective (Galaxy view)
    • Prayer and contemplation
    • Self-love
  • See the links below to get companion resources for this talk

Smoothie recipes: smoothie-recipes

Journaling Starter Kit: journalingstarterkit

Remember to:

Face Your Fears.           BE Ready.             Love Your Life.

Ep. 58 Why Some Doctors Struggle With the End of Life

Click here to read the companion blog on Huffington Post.

In this episode Dr. Karen Wyatt discusses the fact that according to the Nebraska End-of-Life Survey, even though 70% of patients surveyed want their doctors to discuss their end-of-life options but only 21% of them have actually had those conversations.

In addition, while 86% of doctors agree that they themselves would enroll in hospice if terminally ill, only 27% of them are comfortable discussing hospice as an option with terminally ill patients.

There is a huge disconnect between what patients want from their doctor and what they receive and also what doctors would do for themselves at the end-of-life and what they do for their patients.

Today’s conversation looks at reasons for this disconnect to point the way toward changes that are needed in how medicine approaches the end of life. Here are some of the attitudes and mindsets that make it difficult for some doctors to address death and dying, based on conversations between Dr. Wyatt and her colleagues:

  • “It’s not my job. My passion is for saving lives.” Ideally doctors must maintain their passion for life, but must also make room for death, since every patient will ultimately die. Doctors need to cultivate a view of life that includes the reality of death.
  • “I don’t have enough time and the end of life is less important than other issues I’m expected to discuss with patients.” The average primary care visit with an elderly patient last 15.7 minutes and covers 6 topics. Doctors need to view the end of life as the final stage of development and give it the same attention as the other stages of development.
  • “Death represents failure.” While death in general is a natural process and not a failure, for doctors the death of a patient can be a devastating experience, especially if it is unexpected. Doctors carry an enormous burden of responsibility for the health and wellbeing of their patients and mistakes can lead to complications and death. For doctors it is difficult to carry both responsibilities: to preserve life and promote health while also honoring death in its place.
  • “I don’t want to take away my patient’s hope.” Many doctors recognize that optimism and positivity are essential for a patient’s survival and wellbeing. But they view curative treatments as the source of that hope while failing to recognize that hope has many different meanings for patients. They promote ongoing treatment in order to keep hope alive while failing to offer emotional and spiritual support that can foster hope even in the face of death.

By recognizing the obstacles that keep doctors from engaging in end-of-life interactions with patients we can help overcome them over time. It’s important to have compassion for everyone involved as we try to move forward and evolve care at the end of life in our society.

You can support EOLU by making a small pledge of financial support ($1 or $2 per month) at Patreon.com/eolu. Be sure to tune in every Monday for a new episode, leave comments and write reviews on iTunes! Remember to:

Face Your Fears.           BE Ready.              Love Your Life.

 

 

Ep. 57 September End-of-Month Update and film Extremis

 

In today’s episode Dr. Wyatt thanks 3 new supporters on Patreon.com/eolu:

  • Joan Roellchen-Pfohl, RN
  • Martha Johnson – author of the upcoming book “Take Charge of the Rest of Your Life”; learn more at www.meetmarthajohnson.com
  • 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!

Until next week remember:

Face Your Fears.               BE Ready.               Love Your Life!!!

Ep. 56 End-of-Life Book Showcase!

In this episode Dr. Karen Wyatt highlights several excellent books about the end of life that have been sent to her by their authors. If you have considered starting an end-of-life book club (as mentioned in Episode 33) you’ll find many great books to choose from in this list. Here are the book titles and authors, along with links for learning more or purchasing the books:

  • “My Voice, My Choice: A Practical Guide to Writing a Meaningful Healthcare Directive”; by Anne Elizabeth Denny; www.anneelizabethdenny.com
  • “LastingMatters Organizer: Where Loved Ones Find What Matters Most”; by Barbara Bates Sedoric: www.lastingmatters.com
  • “Caring for Dying Loved Ones: A Helpful Guide for Families and Friends”; by Joanna Lillian Brown; www.caringfordyinglovedones.com
  • “Caregivers: Angels Without Wings”; by Peg Crandall; Link to Amazon.com
  • “Changing the Way We Die: Compassionate End-of-Life Care and the Hospice Movement”; by Fran Smith and Sheila Himmel; Link to Amazon.com
  • “Encountering the Edge: What People Told Me Before They Died”; by Karen B. Kaplan; Link to Amazon.com
  • “Spirit Matters: How to Remain Fully Alive with a Life-Limiting Illness”; by Judy Flickinger; www.judyflickinger.com
  • “Spiritual Perspectives on Death & Dying”; by Bernice H. Hill, PhD; Link to Amazon.com
  • “Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond”; by Nancy Manahan and Becky Bohan; Link to Amazon.com
  • “Daddy this is it. Being-with My Dying Dad”; by Julie Saeger Nierenberg; Link to Amazon.com
  • “Leaning into Love: A Spiritual Journey Through Grief”; by Elaine Mansfield; www.elainemansfield.com
  • “Laughing in a Waterfall: A Mother’s Memoir”; by Marianne Dietzel; Link to Amazon.com
  • “Turn Right, Good Moon: Conversations With a Dying Mother”; by L. E. Moore; www.turnrightgoodmoon.com
  • “She Would Draw Flowers: Poems from a Young Artist Awakening to Life, Love and Death”; by Kirsten Savitri Bergh; Link to Amazon.com
  • “And Now, Still: Grave & Goofy Poems and a Bit of Prose”; by Reggie Marra; www.reggiemarra.com
  • “Facing Darkness, Finding Light: Life After Suicide”; by Steffany Barton, RN; Link to Amazon.com
  • “What to Do When You’re Dead: A Former Atheist Interviews the Source of Infinite Being”; by Sondra Sneed; Link to Amazon.com

I hope you’ll check out these amazing and inspirational books and include some of them in your book club or add them to your library!

 

Ep. 54 Film: Love in Our Own Time with Tom Murray

Join Dr. Karen Wyatt and her guest Tom Murray, director of the beautiful feature-length documentary Love in Our Own TimeThey will discuss the making of this film, which follows the lives of ordinary Australians as they face the big transitions of life: birth and death. “Love in Our Own Time is a film that speaks directly to its audience about the nature of life and death. It is a journey to the heart of what it is to be human that gives us all pause to question the lives we lead.” (from the film’s synopsis) Tom Murray reveals his own inspirations for creating the film and the transformation he experienced during the process.

In this interview you will learn:

  • How Tom Murray was inspired to create this film after living and working amongst the Yolngu Aboriginal people
  • How this film is being used in medical education settings to increase awareness about the end-of-life
  • How you might arrange a screening of Love in Our Own Time for your own community

Subscribe to End-of-Life University at http://www.eoluniversity.com so you can receive notification of all the fantastic new interviews on end-of-life issues.

Become a supporter of this podcast by making a donation of $1 or $2 per month at http://www.patron.com/eolu! Thanks!

Check out Dr. Wyatt’s books on Amazon: