A Good Goodbye Radio is launching Wednesday May 1, starting the conversation on end-of-life issues with Martha Hayward of The Conversation Project. This Internet radio program covers a wide range of critical information most people don’t consider until there’s a death in the family.
Why it’s important to have an end-of-life conversation:
60% of people say that making sure their family is not burdened by tough decisions is “extremely important”
56% have not communicated their end-of-life wishes
One conversation can make all the difference.
The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care. Too many people are dying in a way they wouldn’t choose, and too many of their loved ones are left feeling bereaved, guilty, and uncertain.
Download the podcast of this show from the Rock Star Radio Network.
“It’s time to transform our culture so we shift from not talking about dying to talking about it. It’s time to share the way we want to live at the end of our lives. And it’s time to communicate about the kind of care we want and don’t want for ourselves,” says Hayward.
“We believe that the place for this to begin is at the kitchen table—not in the intensive care unit—with the people we love, before it’s too late.”
Martha Hayward joined the Institute for Healthcare Improvement (IHI) in March 2011 as the Lead for Public and Patient Engagement. A cancer survivor, she is a founding board member of the non-profit Women’s Health Exchange and served on the Patient and Family Advisory Council of Dana-Farber Cancer Institute in Boston.
Most recently, as Executive Director at The Partnership for Healthcare Excellence, Hayward brought a particular focus on, and considerable experience in, the area of patient advocacy.
Find out more about The Conversation Project and download your free conversation starter kit from their website: www.TheConversationProject.org.
A Good Goodbye Radio is presented live on Wednesdays at 6:00 p.m. ET / 5:00 p.m. CT / 4:00 p.m. MT / 3:00 p.m. PT on the Rock Star Radio Network. Each program is available in podcast form within 30 minutes of the live program.
Mark your calendars and call in toll-free during the live program to 866-404-6519.
Other guests scheduled for the month of May are: Erika Dillman, author of The Party of Your Life (5/8); Brian Flowers, president of the Green Burial Council (5/15); Valere Beck with MedCure.org on whole body donation (5/22); and Coleen Ellis, co-chair of the Pet Loss Professionals Alliance (5/29).
A Good Goodbye Radio is hosted and produced by Gail Rubin, The Doyenne of Death®. She is the author of the award-winning book A Good Goodbye: Funeral Planning for Those Who Don’t Plan to Die, a Certified Funeral Celebrant, and an engaging speaker who uses funny films to help bring people to consider a topic most would rather avoid.
She brings a light touch to a serious subject and presents expert interviews on “everything you need to know before you go.” More information is available at www.AGoodGoodbye.com.
Filed under: A Good Goodbye TV | Tags: A Good Goodbye, cremation, eco-friendly funerals, end-of-life, green burial, green funerals
Want to “go green” with your funeral or cremation?
Episode Four of A Good Goodbye TV looks at green burial and eco-friendly funerals. While most people associate green only with living, green funerals and green burials provide a way to make end-of-life more meaningful. The discussion includes cremation scattering, funeral resource use and ways to reduce environmental impact.
The guest for this program is Darren Crouch, president of Passages International, which also sponsors the educational website AGreenerFuneral.org. The website introduces the reader to the full spectrum of greener practices one might consider when planning a funeral.
A Good Goodbye host Gail Rubin was interviewed on The Morning Brew program about the debut of A Good Goodbye TV on Albuquerque’s uPUBLIC.tv. Here’s a YouTube video of that interview:
A Good Goodbye: Funeral Planning for Those Who Don’t Plan to Die is currently airing on Albuquerque’s Comcast cable system on the uPUBLIC.tv Channels 26 and 27. Each episode is scheduled as follows:
- On Channel 26, the time slots (which are subject to change) are currently Tuesdays at 4:00 p.m. and Wednesdays at 1:00 p.m.
- On Channel 27, the program airs Thursdays at 5:00 p.m. and Sundays at 9:00 a.m.
- Episodes will also appear on both channels in additional unscheduled repeats.
A Good Goodbye TV is an educational and entertaining 14-episode series of 30-minute programs with expert interviews on “everything you need to know before you go.”
Host Gail Rubin brings a light touch to a serious subject. Like her award-winning book, A Good Goodbye: Funeral Planning for Those Who Don’t Plan to Die, the television program covers information most people don’t know about until faced with a death in the family.
A GOOD GOODBYE DVD SET SPECIAL OFFER
The first 12 programs will become a set of DVDs with three interviews per disc. A Good Goodbye TV interviews will be grouped by content:
- DVD 1 Over My Dead Body: Essentials of Funeral Planning – Preneed funeral planning, cremation, cemetery Q&A
- DVD 2 Trending Topics: Pets, Funeral Parties and Going Green – Pet loss grief and disposition choices, life celebrations and celebrants, green burial and eco-friendly funerals
- DVD 3 Death and Taxes: A Primer on Finances and Funerals – estate planning, financial planning, cost management
- DVD 4 Good Grief! Save Money, Live and Die Better – Medicaid and more, advance directives, grief counseling
SPECIAL OFFER: Place your advance order for the four-DVD set at a 20% discount! The series will retail for $49.97. Place your pre-production order today for only $39.97 plus shipping. A free copy of the book A Good Goodbye will be sent right away to those who place advance orders. CLICK HERE to order.
Filed under: End-of-Life Issues | Tags: end-of-life, speaking, Texas, Vermont
I’m always monitoring news about end-of-life issues. Ironically, in Texas and Vermont, two states where I’m speaking soon, there are currently legislative actions on right-to-die questions.
This recent story in the Austin American Statesman, “Legislators Struggle Again with End-of-Life Decisions,” details an emotionally and politically delicate issue — how to resolve end-of-life disputes when doctors seek to let a patient die against the family’s wishes. A process put in place in 1999 needs reforms, and crafting a plan that is acceptable to all parties is proving impossible.
Some of the issues, as detailed in the article:
In Texas, if doctors believe continued treatment would inhumanely extend suffering in a way that violates their oath to do no harm, they can overrule family wishes by asking the hospital’s ethics committee for approval to halt life-sustaining care — which can include withholding dialysis, ventilators, food and water.
If the committee — often comprising uninvolved doctors, social workers and clergy — agrees, treatment can be halted in 10 days, theoretically giving the family time to accept the inevitability of death or, if they still disagree, to locate a caregiver willing to accept the patient.
The process is intended to shield doctors and hospitals from wrongful death lawsuits while protecting the rights of patients and their families. But in practice, according to testimony at legislative hearings, families can be left scrambling in an unfamiliar system, with an impractical deadline, to find other sources of care.
I’m speaking this Thursday to the North Texas Region of the Texas Funeral Directors Association.
Meanwhile, up north in Vermont, this recent USA Today article “Support Grows in Vermont for an End-of-Life Bill” looks at how terminally ill patients with a prognosis of less than six months to live want to have the right to request and take life-ending medication.
The bill “Patient Choice and Control at End of Life” passed the Vermont Senate in February and goes to the House in March. Although assisted dying is illegal in most states and opponents have been fighting proposals for the past 15 years, support is growing in Vermont and other parts of the Northeast. Connecticut and New Jersey legislators are also examining measures.
Vermont would be the first state to pass a doctor-assisted-death bill through the legislative process. Oregon and Washington voters passed similar bills in voter referendums. Massachusetts voters defeated a measure, 51% to 49%, in November.
Compassion and Choices, a non-profit group dedicated to protecting the rights of the terminally ill, has been actively involved in promoting the Vermont legislation. The organization provides end-of-life counseling, advance planning, and legal casework on end-of-life issues.
Full Disclosure: The New Mexico chapter of Compassion and Choices is a sponsor of my upcoming TV series, A Good Goodbye: Funeral Planning for Those Who Don’t Plan to Die. I admire what they do to help start end-of-life conversations.
I’ll be speaking to the Vermont Funeral Consumers Alliance’s annual meeting on Saturday, May 4, 2013.
Filed under: End-of-Life Issues | Tags: advance directives, end-of-life, Woody Allen
Woody Allen the hypochondriac in Hannah and Her Sisters (1986)
Filmmaker, actor, writer and comedian Woody Allen wrote a brilliant opinion piece in Sunday’s New York Times: Hypochondria – An Inside Look. His essay provides a great conversation starter on advance directives and end-of-life issues.
Allen insists he’s not a hypochondriac but an alarmist. He doesn’t experience imaginary maladies — his maladies are real. He explains:
What distinguishes my hysteria is that at the appearance of the mildest symptom, let’s say chapped lips, I instantly leap to the conclusion that the chapped lips indicate a brain tumor. Or maybe lung cancer. In one instance I thought it was Mad Cow.
The point is, I am always certain I’ve come down with something life threatening. It matters little that few people are ever found dead of chapped lips. Every minor ache or pain sends me to a doctor’s office in need of reassurance that my latest allergy will not require a heart transplant, or that I have misdiagnosed my hives and it’s not possible for a human being to contract elm blight.
Even though he is in great health and takes great care with vitamins, supplements and exercise, still, the fear lurks.
But what’s this obsession with personal vulnerability? When I panic over symptoms that require no more than an aspirin or a little calamine lotion, what is it I’m really frightened of? My best guess is dying. I have always had an animal fear of death, a fate I rank second only to having to sit through a rock concert. My wife tries to be consoling about mortality and assures me that death is a natural part of life, and that we all die sooner or later. Oddly this news, whispered into my ear at 3 a.m., causes me to leap screaming from the bed, snap on every light in the house and play my recording of “The Stars and Stripes Forever” at top volume till the sun comes up.
I sometimes imagine that death might be more tolerable if I passed away in my sleep, although the reality is, no form of dying is acceptable to me with the possible exception of being kicked to death by a pair of scantily clad cocktail waitresses.
The real fear, though, is experiencing a fate worse than death: a debilitating stroke, a coma (when he’s aware and can’t change the channel from Fox News), or being on life support and hearing relatives argue about pulling the plug. The worst is ending up a living vegetable.
This is a great humor-filled essay to help start those advance directive conversations with your family. Read the essay and start a conversation today!
How do we find the words to say a good goodbye? At the tenuous end-of-life time, what do we say to the dying when we don’t ever exactly know the precise moment when someone will die? What do the dying say to us – or not?
A column by Bruce Feiler in the New York Times explores these questions. His column Exit Lines looks at what people say, or don’t say, leading up to death in real life versus what gets said in the movies. He gives examples of screenwriter Nora Ephron and film reviewer Gene Siskel, who both died without informing people much in advance of the seriousness of their diagnoses.
Feiler poses the question, “What is the best thinking about how to make farewell conversations less stressful and more meaningful?” His interviews with film reviewer Roger Ebert, Joan Halifax, the abbot of Upaya Zen Center in Santa Fe, N.M., Ira Byock, the director of palliative care at Dartmouth-Hitchcock Medical Center, and others provided great insights.
Here are suggestions, breaking it down into these categories:
- Say Nothing: Life-extending medical machinery can keep people alive, sort of, indefinitely. You never know when the last day will be.
- Say Something Before It’s Too Late: To avoid the issue of timing, as well as the deterioration that often afflicts terminal patients, many experts advise having important conversations while everyone is still able.
- Say The Obvious: Keep it simple and don’t worry about trying to be eloquent – “Please forgive me.” “I forgive you.” “Thank you.” “I love you.”
- Say It With Deeds: Do something for or with the patient that expresses how you feel.
- Say It Even If They Can’t Hear You: Everyone Feiler spoke to said you should still have a farewell conversation, even if it’s one-way.
Check out all the information in this excellent This Life column. Don’t be afraid to start a conversation.
Filed under: End-of-Life Issues, Guest Blog Posts | Tags: end-of-life, Engage With Grace
This Thanksgiving, with the family gathered ’round, have a conversation about end-of-life issues. Please consider these thoughts from my friends at Engage With Grace, eloquently explaining why this is a very good thing to do.
Engage With Grace
One of our favorite things we ever heard Steve Jobs say is… ‘If you live each day as if it was your last, someday you’ll most certainly be right.’
We love it for three reasons:
1) It reminds all of us that living with intention is one of the most important things we can do.
2) It reminds all of us that one day will be our last.
3) It’s a great example of how Steve Jobs just made most things (even things about death – even things he was quoting) sound better.
Most of us do pretty well with the living with intention part – but the dying thing? Not so much.
And maybe that doesn’t bother us so much as individuals because heck, we’re not going to die anyway!! That’s one of those things that happens to other people….
Then one day it does – happen to someone else. But it’s someone that we love. And everything about our perspective on end of life changes.
If you haven’t personally had the experience of seeing or helping a loved one navigate the incredible complexities of terminal illness, then just ask someone who has. Chances are nearly 3 out of 4 of those stories will be bad ones – involving actions and decisions that were at odds with that person’s values.
And the worst part about it? Most of this mess is unintentional – no one is deliberately trying to make anyone else suffer – it’s just that few of us are taking the time to figure out our own preferences for what we’d like when our time is near, making sure those preferences are known, and appointing someone to advocate on our behalf.
Goodness, you might be wondering, just what are we getting at and why are we keeping you from stretching out on the couch preparing your belly for onslaught?
Thanksgiving is a time for gathering, for communing, and for thinking hard together with friends and family about the things that matter. Here’s the crazy thing – in the wake of one of the most intense political seasons in recent history, one of the safest topics to debate around the table this year might just be that one last taboo: end of life planning. And you know what? It’s also one of the most important.
Here’s one debate nobody wants to have – deciding on behalf of a loved one how to handle tough decisions at the end of their life. And there is no greater gift you can give your loved ones than saving them from that agony. So let’s take that off the table right now, this weekend. Know what you want at the end of your life; know the preferences of your loved ones. Print out this one slide with just these five questions on it.
Have the conversation with your family. Now. Not a year from now, not when you or a loved one are diagnosed with something, not at the bedside of a mother or a father or a sibling or a life-long partner…but NOW. Have it this Thanksgiving when you are gathered together as a family, with your loved ones.
Why? Because now is when it matters. This is the conversation to have when you don’t need to have it. And, believe it or not, when it’s a hypothetical conversation – you might even find it fascinating. We find sharing almost everything else about ourselves fascinating – why not this, too? And then, one day, when the real stuff happens? You’ll be ready.
Doing end of life better is important for all of us. And the good news is that for all the squeamishness we think people have around this issue, the tide is changing, and more and more people are realizing that as a country dedicated to living with great intention – we need to apply that same sense of purpose and honor to how we die.
One day, Rosa Parks refused to move her seat on a bus in Montgomery County, Alabama. Others had before. Why was this day different? Because her story tapped into a million other stories that together sparked a revolution that changed the course of history.
Each of us has a story – it has a beginning, a middle, and an end. We work so hard to design a beautiful life – spend the time to design a beautiful end, too. Know the answers to just these five questions for yourself, and for your loved ones. Commit to advocating for each other. Then pass it on. Let’s start a revolution.
Engage with Grace
Filed under: End-of-Life Issues, Friday Funeral Films | Tags: advance directives, end-of-life, Funeral Films, funeral planning
Today’s Friday Funeral Film, The Descendants starring George Clooney, helps start funeral planning conversations around advance directives and end-of-life issues. It also shows how a party can be the center of a good goodbye BEFORE someone dies. You also get a good look at cremated remains, if you’ve never seen them up close.
Hawaiian land baron Matt King (Clooney) has been having marital issues with his wife Elizabeth. The film opens with her riding in a powerboat race. The director Alexander Payne infers the accident that puts her in a vegetative state. As the film starts, we hear Matt’s thoughts as he sits in her room, looking at her motionless body on life support. He’s been there for 23 days.
“We hadn’t spoken in days. In a way, we hadn’t really spoken in months,” he says. “If you’re doing this to get my attention, Liz, it’s working. I’m ready now. I’m ready to talk. I’m ready to change. I’m ready to be a real husband and a real father. Just wake up. Please Liz, just wake up.”
This internal dialogue reminds us of the importance of being present with those we love, every single day. It can be so easy to let other interests and daily concerns crowd out our attention to the people closest to us in our families. It also lets us know he has been a less-than-attentive father to his two girls, and he’s about to find out his wife has been unfaithful to him.
The Importance of Advance Directives
Early on, Matt gets the news that Elizabeth’s condition has deteriorated. She has no eye or brain stem responses. Three doctors have determined she will never recover. She had an advance directive stating she does not want to be kept alive by artificial means. Matt asks if she’s taken off the machines, and the doctor says, “It’s not if but when.” The doctor says he has a legal obligation to take her off of life support.
Matt asks how long she will last, and the doctor says, “It’s hard to say, it could be a few days, it could be a couple of weeks… I know I’ve got to get the ball rolling on the organ donations right away.” He advises Matt to get Elizabeth’s many friends in to say goodbye as soon as possible.
This scene is instructive on several fronts. The doctor breaks the news as gently as he can, and he displays great empathy. Both are sitting together at a table leaning in toward each other, making eye contact. The fact that Elizabeth had advance directives regarding life sustaining measures in case of vegetative conditions and she wanted her organs donated provides a role model for others. She shows you’re never too young to put these directives in place.
The Good Goodbye Party
Matt hosts a swell party gathering Elizabeth’s friends together (close up on fabulous food and drinks). Matt addresses the assembled crowd saying, “You’ve all asked questions about Elizabeth and I’ve given vague answers. But I’ve asked you all here today to tell you that her coma is permanent. She’s not going to make it. So this week, tomorrow in fact, as per her wishes we are going to unhook her from life support… I wanted to tell you all in person because you are all our dear friends, our best friends.”
A woman asks if people can go see her. Matt replies, “Yes, that’s the whole point, go see her as soon as possible… Everyone who loves Elizabeth deserves a chance to say goodbye.”
How many people would have the courage to take this public step to help your community process a forthcoming death like this? And with such style! In a way, this was the memorial service for Elizabeth while she was still alive. There is no memorial service shown later in the film.
Is it just me who has an issue with the well-used phrase, “He/She’s not going to make it”? I suppose the “make it” refers to making it back to health. Death is the ultimate finish line. She was just about to make it there.
Scattering Cremated Remains
Toward the end of the film, Matt and his two daughters go out on Honolulu Bay to scatter Liz’s ashes. The three of them sit in a decorated long boat. Each pour some of her remains into the water that she loved to boat upon. After all of the ashes are poured out, they remove their leis and float them upon the water. The last shot in the scene shows them from underwater, floating on the surface, making the shape of hearts.
This is a wordless scene, and yet you can see the emotion on the faces of the daughters and Matt. It’s a ceremony for the immediate family, a good goodbye.
The Descendants was released in 2011 and is rated R. It’s available on Netflix and can be purchased (as available) from Amazon.com.
Here’s one of the trailers:
How much money would you spend to keep your elderly parents alive in the hospital? Because of Medicare, most families don’t have to ask themselves that tough end-of-life question.
Perhaps families should start to consider how they would respond.
This eye-opening story that originated in the St. Louis Post-Dispatch traced the six-month decline of an 89-year-old woman. She had Alzheimer’s, was placed on a feeding tube when she could no longer eat, then was placed on a respirator when she could no longer breathe on her own.
The day came that the doctor said to the woman’s three children that it was time to let Mom die. The two daughters agreed, but the son refused, wanted everything possible done to keep her alive, and bolted from the room.
As the article stated, such wrenching dilemmas test not only family bonds and the frontiers of medicine, but the nation’s tolerance for runaway health care costs. In the final six months of her life, this woman’s care totaled about $1.2 million, according to billing records provided by the family.
How many families would pay for this kind of life-extending medical care if they had to pay it themselves? This is when the death panel conversation becomes real – and the panel is comprised primarily of the offspring of that person in the hospital bed.
From the article:
As the debate over the Supreme Court’s ruling on the national health care overhaul law continues, many experts say that the ethical and financial dynamics of dying should be front and center. Yet few politicians, bureaucrats, insurers and doctors dare even to discuss it. And no one seems to have a clue as to how our society can afford to pay national health costs that approached $2.6 trillion in 2010 — a tenfold increase since 1980, according to the Centers for Medicaid and Medicare Services.
When the elderly can survive only with aggressive measures, the incentives for all involved tilt toward treatment, regardless of cost. Family members naturally want loved ones to live. Physicians and hospitals get paid well for providing extensive medical treatment — and face legal liability for denying care, even if the patient has scant survival prospects.
Insurance companies likewise fear being vilified and sued for denied care, and can preserve profit margins by passing along the costs to employers and their workers. And the Medicare program ultimately reports to Congress, which has shown no willingness to wade into the political deadly arena of near-death care — or curbing federal health entitlements at all.
The financial train wreck is coming and our current healthcare system only stokes the boilers. The Silver Tsunami of baby boomers is starting to build. We need to have these serious conversations with our partners, our siblings and our parents now, before illness and disability strike.
