Ep. 78 Change Happens: How to be Prepared for the Ultimate Transition

What does it take to be ready and at peace when you reach the end of life? Here are some thoughts on how to prepare.

 

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In this episode we’ll take a look at what you need to do to prepare for the future, particularly the end of life. You’ll find out how to BE Ready for whatever life brings your way!

ANNOUNCEMENT:

slide01The Roadmap for End-of-Life Planning Course is finally available! Click here to learn more.

This 4-module course is like having your own personal consultation with an end-of-life physician (me!) who guides you through completing your paperwork one step at a time!

Check it out!

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! THANK YOU to my latest patron Sylvie and to all current patrons!!

IN THE NEWS:

  1. Facebook announces it will offer employees up to 20 days of paid bereavement leave and 6 weeks of paid leave to care for an ill loved one.
  2. A study done by U of Colorado Anschutz showed that oncologists are reluctant to have conversations with patients about their prognosis and patients seem equally unwilling to discuss the difficult facts about their diagnosis. This demonstrates the need for better preparation for the end of life BEFORE the onset of a life-limiting illness.

Change Happens: How to be Prepared for the Ultimate Transition

17153795 - are you ready illustration design over a white backgroundWhat steps should you take now to be fully prepared for later life? I like to break them down into 3 categories: Paperwork, People, and Purpose.

Here are some suggestions for your own preparations:

  1. Paperwork:
  • Make sure you have completed an estate plan and/or will to protect your financial assets
  • Appoint someone to be your financial power of attorney AND a separate  person as your medical power of attorney
  • Complete your advance directive (or living will)
  • Plan for your funeral and burial
  • Gather important documents, account numbers, passwords, etc. into on file where they will be accessible in the future (Check out the BE Ready Checklist for a list of all these documents you should gather)

2. People:

  • Tie up “loose ends” in your life by practicing forgiveness
  • Make amends with the people closest to you
  • Say “I love you” whenever you have the opportunity
  • Talk with your loved ones about your healthcare wishes
  • Talk with your doctors (and also spiritual advisor or attorney if relevant) about your end-of-life wishes
  • Be prepared to care for an ill or dying loved one at home if that should become necessary

3. Purpose:

  • Think about your own sense of meaning and purpose in life–are you living life fully in each moment?
  • Practice being present in the moment by taking up mindfulness or using deep breathing
  • Recognize that your purpose is not really something you hope to accomplish in the future; it lies in how you live your life each moment
  • Face your fear of death so that you can fully prepare and then relax and enjoy all that your life offers to you

Click here to download the End-of-Life Preparedness Assessment to see if you are ready!

Tune in every Monday for a new episode. Until the next time, remember:

Face Your Fears.                     BE Ready.                Love Your Life.

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Ep. 77 Managing Family Conflict at the End of Life

What do you do when a family (your own or a patient’s) is crumbling due to unhealed resentments and irreconcilable differences? Find out now.

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In today’s episode I’ll share my best tips for helping families move through conflict toward resolution during stressful times like the death of a loved one. I’ve had lots of experience with this work during my years as a hospice doctor so be prepared for a longer-than-usual episode!

Announcements:

slide01My new course Step-by-Step Roadmap for End-of-Life Planning is almost ready for release (just a few days away as I record this!) The course is simple yet comprehensive and will help you examine your mindset, values, beliefs, and fears about death before you make decisions about your end-of-life healthcare. Go to eoluniversity.com/roadmap to learn more and sign up to be notified as soon as the course is released.

Sponsorship:

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! THANK YOU to all current patrons!!

Managing Family Conflict at the End of Life:

Families facing the death of a loved one are particularly prone to be divided by the resurgence of old conflicts and resentments. Over my years as a hospice doctor I have seen many families split apart by their differences at a time when they most need to be united.

Most of these families had longstanding grievances that had been buried and ignored over the years, only to rise to the surface under the stress of a loved one’s death. Sibling rivalries, parental favoritism, divorce, and competition for inheritances are the most common reasons for these resentments. In addition many families are also divided over religious and political differences, which is an especially prevalent problem right now.

One of the important functions of hospice staff members and other end-of-life workers is to assist splintered families with healing and resolution of their conflicts, whenever possible. But sometimes we are called to assist our own families when challenges arise. Here are some tips for being a peacemaker for a fractured family:

  • Remain neutral on the issues of conflict. As much as possible leave your own biases, preferences and beliefs at the door if you hope to help resolve a disagreement. This will be much easier if you are not emotionally entangled in the conflict. But even if you are, you need to learn to become a “Witness” to the situation (a higher state of consciousness that allows you remain detached.)
  • Listen to all sides of the argument. Spend time with each person involved in the conflict until you can grasp their perspective. If you are part of the disagreement then at least try to understand the point of view of the others involved in the situation. As soon as you begin to understand how and why the others feel the way they do then you have taken a huge step toward reconciliation.
  • Avoid trigger topics. Political and religious differences may complicate family conflicts at the end of life but are usually not reconcilable. So it is best to “agree to disagree” about these points of view and set them aside so that the focus can be on healing other issues.
  • Be present. By staying calm and unemotional you can prevent the conflict from escalating into an all-out war. Practice mindfulness to help strengthen your ability to be present so that your own emotions don’t flare up when you are trying to help others.
  • Find common ground. As you listen carefully to the stories of each opponent in the disagreement you may recognize certain common threads–areas where they actually share the same perspective without realizing it. Gather these threads so that you can remind those in conflict that are some things they have in common. Help them untie around the things that matter most (like doing what’s best for their loved one.)
  • Learn the wishes of the dying loved one (if possible.) If you can still communicate with the patient you may find out that she has a wish for her family to reconcile. You can use this wish to help draw the combatants together in their desire to please and comfort the one they love. Let the patient’s wishes become a “magnet” around which the rest of the family gradually comes together.
  • Have patience. Don’t try to force a reconciliation by rushing into a family conference or intervention. Allow for some separation initially and let the gaps between individuals gradually begin to close.

The bottom line is that families who don’t wait until the end of life to resolve their differences have a much easier time negotiating the challenges of death and dying. But that’s not the case for most families. Most are left to rehash old sibling issues, betrayals, disappointments, and wounds during the last days of their loved one’s life when they should be sitting at the bedside offering love and comfort.

Start working through your own resentments now–practice love and forgiveness earlier in life and your final days will be blessed. If you need extra help consider checking out the Step-by-Step Roadmap for End-of-Life Planning or the book What Really Matters. You’ll find guidance and support from me for your journey!

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Tune in every Monday for a new episode! Until next week remember:

Face Your Fears.                 BE Ready.                   Love Your Life.

karen-signature

Ep. 75 Perfect Your Paperwork: Mistakes to Avoid in Your End-of-Life Planning

It’s not enough to get your paperwork done … make sure it’s done right!

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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!

supportonpatreon-e1412764908776This 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.

slide01The course “Step-by-Step Roadmap for End-of-Life Planning” is self-paced and can be completed any time, anywhere.

I’ve written the course to help people be prepared mentally and emotionally to make end-of-life decisions and avoid the common mistakes discussed below.

Learn more about the course at www.eoluniversity.com/Roadmap.

Common mistakes in end-of-life planning include:

  • Putting it off for a later time
  • Not completing the forms entirely
  • Choosing contradictory options on the forms
  • Choosing the wrong healthcare proxy
  • Getting lost in the details of possible scenarios at the end of life
  • Not discussing plans with the doctor
  • Not expressing wishes to loved ones
  • Not updating end-of-life preferences over time

The Step-by-Step Roadmap for End-of-Life Planning is designed to avoid all of these mistakes and to aid in making the right choices for future healthcare needs.

Thanks for tuning in to the podcast! Until next week:

Face Your Fears.                      BE Ready.                   Love Your Life.

 

 

Ep. 64 It’s Okay to Die with Monica Williams-Murphy MD

 

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!

 

 

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!