End of Life, EOLPodcast

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.

End of Life, EOLPodcast

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!

 

 

End of Life, EOLPodcast, Hospice

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.

 

Aging, End of Life, EOLPodcast, Grief

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!!!

End of Life, EOLPodcast, Grief, Hospice, Spirituality

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!

 

EOLPodcast

Ep. 55 How to Talk to Your Healthcare Provider About Your End-of-Life Wishes

Today Dr. Karen Wyatt discusses how to start an end-of-life planning conversation with your healthcare provider. She suggests the following:

  • Don’t wait for your provider to bring it up – initiate the conversation yourself
  • Schedule a dedicated appointment for advance care planning rather than trying to add it on to a regular visit or wellness exam
  • Be prepared by completing either The Conversation Starter Kit or the SMART Decisions Challenge before your visit
  • Choose your healthcare proxy in advance and make sure that person is willing to serve this role on your behalf
  • Print your paperwork in advance by going to caring info.org and downloading the forms needed for your state(s) of residence
  • Bring along a list of your questions
  • Return for a follow-up conversation in 2-4 weeks. Then plan to revisit your decisions every 5 years or whenever your health status changes.

Remember to subscribe to End-of-Life University interview series on the website.

If you’d like to support EOLU with a small donation go to Patreon.com/eolu.

Tune in next week and until then:

Face Your Fears.           BE Ready.            Love Your Life.

End of Life, EOLPodcast

Ep. 51 The Truth About Advance Directives from a Doctor’s Perspective

In this episode Dr. Wyatt thanks her supporter Cathy Zheutlin who is a film producer currently making a documentary called “Living While Dying.” If you would like to support this podcast go to Patreon.com/eolu where you can make a donation of $1 or $2 per month to help defray the expenses of the podcast. Your name will be mentioned on the podcast as a thank you!

Dr. Wyatt discusses Advance Directives from a doctor’s point of view and relates stories about situations involving “the good, the bad, and the ugly” of this legal paperwork. The discussion includes:

  • AD’s are legal forms best applied to long-term situations and  can be helpful to prevent or terminate life-supporting care that is actually prolonging suffering and the dying process
  • we may wish that having AD’s in place will give us some measure of control over the circumstances of our death, but this is often not the case – there are many scenarios in which wishes cannot be carried out
  • AD’s are no substitute for having conversations with loved ones about our end-of-life wishes
  • be sure to communicate your wishes with everyone who might have a stake or concern about your dying process – make sure everyone hears the same message
  • update your loved ones whenever your wishes change
  • face your own fears of dying and of being kept alive in order to be extremely clear about your wishes – revisit these thoughts frequently
  • recognize that in the end circumstances may be out of everyone’s control and your wishes may not be followed. Find peace with that scenario and help alleviate any guilt your loved ones might carry if your wishes are not met.

Tune in next week for another episode of EOLU! Sign up for the End-of-Life University Interview series – 2 new interviews each month about all aspects of death and dying. Register here to be notified when the next interview is available.

Until next week:

Face Your Fears.          BE Ready.           Love Your Life.

 

End of Life, EOLPodcast

Ep. 39 Why It’s Important to Think About Death with Karen Wyatt MD

In this episode Dr. Wyatt shares her thoughts about why each of us should think and talk about death long before we are dying. But before that she discusses her recent speaking tour with presentations at the Afterlife Awareness Conference in St. Louis MO and the Conscious Dying Panel Discussion she moderated; the New Death & Dying Event in Minneapolis MN and an additional speaking event in Rochester MN.

You can support this podcast by donating to Patreon.com/eolu. This week the featured patron is Jim Erskine, creator of the Expired “card game for mortals,” who will be soon be launching a Kickstarter campaign for the game. To become a featured patron just go to Patreon.com/eolu and make a small donation!

For those who are reluctant to talk or think about death, here are 5 compelling reasons why it’s important to do so:

  • Preserve your financial legacy
  • Protect your minor children
  • Get the kind of care you want at the end-of-life (or be protected from care you don’t want)
  • Be remembered as you would like to be by your loved ones
  • Lessen the stress for your loved ones

Leave comments and reviews on iTunes to help this podcast get noticed, share with your friends, and become a patron (if you are so inclined.)

Meanwhile, remember to:

Face Your Fears.      BE Ready.       Love Your Life.

 

 

 

 

End of Life, EOLPodcast

Ep. 35 April End of Month Update on the End-of-Life with Dr. Karen Wyatt

Today Dr. Karen Wyatt offers the End of Month Update for April 2016. In this episode she recaps the 10-Day SMART Decisions Challenge for completing your advance directives – if you are interested in still doing the challenge on your own time you can check it out at www.eoluniversity.com/challenge. Also be sure to check out the EOLU page at Patreon.com/eolu if you’d like to make a small monthly donation to help keep EOLU on the air (much appreciated!)

Topics discussed in this presentation include:

  • A study showing that the population of people over age 65 will increase to 88million by the year 2050 – meaning there will be a huge need for services for the elderly. Reference to Episode #08: It Takes A Village to Care for the Elderly.
  • New “Affinity-Based” senior living communities are springing up around the country like Chinese-American and Indian-American communities.
  • The Harvard Study of Adult Development, which started in 1938, has shown that relationships are the key to a long happy life.
  • A British study in which the extreme elderly (over the age of 95) were interviewed about death and dying showed that they were at peace with death, ready to go and had talked with their doctors about death, but not their families.
  • A newly released survey of doctors found that they overwhelmingly support new CPT codes that allow for billing for end-of-life conversations and planning with patients but most of them report they are not ready to have these conversations because they have not been trained and don’t know what to say.
  • The Credit for Caring Act is currently being discussed in the US Congress and would provide up to $3000 per year in tax credits for family caregivers.
  • “Presenteeism” is a new term to describe the lack of productivity on the job experienced by family caregivers who are also employed outside the home (which amounts to 20% of Americans.)
  • Reports of funeral ritual behavior from the animal kingdom.
  • Driving Miss Norma – the story of a 90-year-old woman who said “no” to treatment after her cancer was diagnosed and is currently traveling the US in an RV with her son and daughter-in-law.

Be sure to leave comments below, subscribe to the podcast, write reviews, and recommend EOLU to your friends. Looking forward to our next opportunity to chat about the end-of-life!

Check out the website: eoluniversity.com

End of Life, EOLPodcast

Ep. 34 Begin the Conversation with Kimberly Paul

Today’s focus is on advance care planning as Dr. Wyatt shares an interview with Kimberly Paul of Lower Cape Fear Hospice, who is the creator of the Begin the Conversation Workbook and Toolkit. You’ll learn about National Healthcare Decisions Day and Dr. Wyatt’s 10-Day SMART Decisions Challenge, which you can join for free at www.eoluniversity.com/challenge and get your own advance directives done with Dr. Wyatt’s guidance.

In the interview Kimberly will share:

  • How the BTC Toolkit can be used to introduce the concept of Advance Care Planning to people of all ages
  • The 7 step process recommended in the BTC Workbook
  • How Begin the Conversation differs from other advance care planning resources
  • How to access the tools offered by BTC

Learn more about BTC at www.begintheconversation.org

Sign up for End-of-Life University at www.eoluniversity.com or by texting EOLU to 38470.

Remember to check out the Patreon page for this podcast and make a donation if it suits you at www.patreon.com/eolu

Thanks for listening! Take care and get your advance directives done!

End of Life, EOLPodcast

Ep. 31 March End of Month Update on the End-of-Life with Dr. Karen Wyatt

Dr. Karen Wyatt discusses what’s new and noteworthy in the end-of-life arena this month:

  • Medscape article reveals that 1/3 of all people in the US with advance directives actually request more medical intervention at the end-of-life, rather than choosing to limit medical intervention; question: What is “futile” care?
  • Helsinki, Finland project allows young people to live at low cost within senior living centers in exchange for interacting with the elderly residents
  • PEACH program in Toronto provides mobile palliative care to the homeless
  • France has a “deep sleep bill” allowing terminal sedation that has passed the lower house of parliament
  • National Geographic article shows interesting death customs of Torajan people of Indonesia
  • Demonstration project for curative care occurring simultaneously with hospice care may be doomed because criteria for participation is too narrow and numbers are too small
  • Video game “That Dragon, Cancer” has been released
  • Stanford Letter Project is an interesting resource for creating advance directives in the form of a letter to physician, family members
  • Parting.com has an interactive map that shows funeral costs in each state of the US; discussion about living funerals
  • Tribute to 13 yo Delaney Clements who died this week and left us with a beautiful , joyful video expressing her wishes for her funeral
End of Life, EOLPodcast

Ep. 28 Action Steps for Improving End-of-Life Care in Your Community with Karen Wyatt MD

Click here to get the handout for this talk!

Today Dr. Karen Wyatt discusses several “Action Steps” you can take in your own community to help improve end-of-life care. Change begins with the individual and if you want to ensure that your own dying is handled with respect and dignity then you should start now to help implement change. This podcast offers tangible steps you can take–some are easy, some will require a lot more effort–to get your community talking about and making changes in how death and dying are managed. Some of the tips include:

  • Starting a Death Cafe
  • Creating an End-of-Life Book Club
  • Presenting a film series on the end-of-life
  • Volunteering for hospice
  • Teaching a death and dying class
  • Hosting a Death Over Dinner event
  • Facilitating a 5 Wishes workshop

Get the handout for this talk at http://tinyurl.com/eolaction

End of Life, EOLPodcast

Ep. 06 Five Wishes for the End-of-Life

This interview is with Paul Malley, President of Aging With Dignity, a national non-profit organization that created the Five Wishes document for recording end-of-life preferences. In this interview you will learn:
-Why, how and when you should create an advance directive
-The most important question addressed by an advance directive, especially Five Wishes
-How to talk to your loved ones about your wishes at the end-of-life