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. 102 Supernatural Stories from the Dreams of a Hospice Physician

podcastdreams

In this episode I’ll share my own “supernatural” dreams that occurred while I was caring for hospice patients. It’s time to come forward and talk more openly about these experiences to help shed light on the dying process and the after-death realms.

ANNOUNCEMENTS:

An Evening withDr. Ira Byock

Register now for “An Evening with Ira Byock MD” which will take place on Monday August 21st at 6 pm Pacific/9 pm Eastern. We will be celebrating the 20th Anniversary of his groundbreaking book Dying Well. Dr. Byock and I will discuss the changes in palliative and hospice care that have taken place over the past 20 years and what changes still must occur to ensure that everyone has the opportunity to “die well.”

Click here to learn more and register (it’s free and you’ll receive the replay if you can’t attend live.) You’ll also receive the Dying Well Readers Discussion Guide – a very helpful resource for leading a book group or workshop on Dying Well.

Patreonbecome2xThis podcast is supported by generous donations to my page at Patreon.com/eolu. A HUGE “Thank you” goes out to my latest donor: Jane Duncan Rogers of BeforeIGoSolutions.com – a non-profit located in Scotland. And thanks as well to all of the other supporters who are chipping in a few $ per month to help keep the podcast and the End-of-Life University Interview Series on the air! Learn more or become a patron at Patreon.com/eolu.

PERSONAL NEWS:

OLYMPUS DIGITAL CAMERAI am currently planning an Autumn trip to Italy where I will be eating amazing food, viewing sacred sites, cycling, and researching a new book on grief. You can view my Pinterest board if you are interested in seeing all the locations on my “wish-list” for the trip. Feel free to make suggestions if you have a favorite spot in Italy that I shouldn’t miss! I’ll be sharing photos on Instagram and Facebook once the trip begins.

PRESENTATION:

This week I attended a meeting at the IANDS 2017 Conference in Denver (International Association for Near Death Studies.) I sat together in a small circle with individuals from all around the country who have had near-death experiences and also with end-of-life caregivers who have had unusual “supernatural” experiences while working with the dying.

I was impressed by the courage of the group members who were willing to share their stories and risk being labelled as “flakey” or even crazy. And that’s what inspired me to record this podcast episode. 

During my work with hospice patients on multiple occasions I experienced vivid dreams where I saw my patients in “soul form” (or a disembodied state) before they had actually died. These dreams brought me much comfort and also eased my fear of death. On some occasions I was able to share the dreams with family members who were comforted, as well, by the visions I had seen.

I have never shared these dreams publicly out of a fear of being ostracized by the medical profession. But the time for secrecy has long passed and we need transparency and truth in all matters surrounding death and dying. So I’m telling these stories in hopes that others might be inspired to talk openly about their experiences as well. If you have a story to tell but no one to share it with I hope you will email me at karen@karenwyattmd.com and describe your experience – let’s support one another!

Tune in next week for another new episode. Until then remember ….

Face Your Fear.                   BE Ready.                   Love Your Life.

karen-signature

Ep. 71 The Death-Positive Movement: Trends and Goals for 2017

It’s a brand new year! Let’s look ahead and see what’s possible in 2017!

blogtemplate2017

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 supportonpatreon-e1412764908776Patreon.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/eolu and sign up to contribute just $1 or $2 per month.

Here are some of the Trends I’ll be watching in 2017:

  1. 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.
  2. 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:
    1. Sebastopol CA: Jerrigrace Lyons http://finalpassages.org
    2. Austin Texas: Donna Belk (Online training program): http://beyondhospice.com
    3. Austin Texas: Deanna Cochran http://www.qualityoflifecare.com
    4. Ann Arbor Michigan: Merrilyn Rush and Patty Brennan http://center4cby.com This training starts right away – Feb. 3-5, 2017
    5. Calgary Canada: Sarah Kerr http://soulpassages.ca/about/
    6. New York and online: Suzanne B. O’Brien RN: http://www.doulagivers.com
  3. 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.
  4. 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:
    1. Plan a community end-of-life event.
    2. Start a Death Cafe.
    3. Plan an EOL Film Festival.
    4. Start an EOL Book Club. Get a list of potential books here.
  5. 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.
  6. 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.
  7. Provide education for your community either as a voluntary act of service or as a paid instructor. Here are some possible ideas:
    1. Assist people to correctly complete their advance directives.
    2. Teach a community class on death and dying.
    3. Train caregivers.
    4. Teach about green burial, promote a natural burial ground in your community, help people access green burial supplies
    5. Educate the community about their rights to a home funeral

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.

Until next week ….

Face Your Fears.              BE Ready.             Love Your Life.

Ep. 70 Looking Back on 2016: A Positive Year for End-of-Life Issues

In this final episode of 2016 Dr. Wyatt thanks all of the patrons who have generously made contributions on Patreon.com/eolu this year! Thank you for offering your support for this podcast and the End-of-Life University interview series!

In this look back at 2016 we talk about the following positive events in the end-of-life arena:

  • In January JAMA dedicated a special issue to “Death, Dying and the End-of-Life”, which represents a positive breakthrough in awareness of EOL issues by the medical profession
  • Medical schools began adopting new training programs for students in pain management, palliative care, and communication skills around advance care planning. There is a college-level program that pairs pre-med students with hospice patients
  • Nursing homes and long-term care facilities are bringing in children and college students to interact with patients
  • Dementia rates in the US  have dropped in the past year
  • Pilot studies are underway involving providing education and training to family caregivers and providing a small stipend to caregivers
  • A demonstration project is underway to study the benefits of providing curative care simultaneously with hospice care
  • Studies showed that palliative care lowers healthcare costs along with providing increased quality of life, improved pain management and fewer hospital days
  • Harvard study of adult development showed that relationships are a key to longevity
  • California and Colorado both passed assisted dying laws in 2016
  • The nation’s first conference on VSED was held this year
  • Conversation Sabbath took place for the first time in November, bringing discussions about death and dying into places of worship
  • Dying to Know Day was held in the US, inspired by the movement in Australia
  • Miss Norma, a 90-year old woman who refused treatment for her cancer, spent most of the year traveling around the country in an RV with her son and daughter-in-law, fully enjoying the last days of her life

Thank you for tuning in to the EOLU Podcast during 2016! I hope this has been a positive and productive year for you. May 2017 be filled with growth, surprises, peace and joy! See you next year and until then …

Face Your Fears.              BE Ready.              Love Your Life.

Ep. 66: November End of Month Update on the End of Life

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

Tune in every Monday for a new episode! Subscribe and leave reviews on iTunes by going here: https://itunes.apple.com/us/podcast/end-of-life-university/id1033282990 

Until next week remember:

Face Your Fears.                     BE Ready.                       Love Your Life.

Ep. 65 Changing the Perspective on Death: Highlights from Death Expo 2016

meaningchangede

 

 

In this episode Dr. Karen Wyatt shares her favorite “take-aways” from the 12 presentations of the recent Death Expo event. If you missed Death Expo you can still purchase the recordings from the event for just $36 (which is a great price for 12 hours of education.)  Go to this link to learn more. The speakers she highlights are:

Enjoy these highlights! If you feel inspired, consider purchasing the Collection!

Also visit the Patreon.com/eolu page if you’d like to become a supporter! As always:

Face Your Fears.                   BE Ready.                     Love Your Life.

Ep. 62 October End-of-Month Update – Halloween Edition

 

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:

Face Your Fears.                 BE Ready.                Love Your Life.