This conversation isn’t easy, but I did it anyway : Engage with Grace

It’s blog rally time!

This is year 4 of  “Engage with Grace” (oops, I skipped 2010, but I was there for 2008 and 2009) which is about having conversations to know the values of ourselves and our loved ones when it comes to end of life care, and end of life living, really. This year’s rally request came via a soothing, helpful reminder, not in all caps, from my good friend Alexandra Drane ( @adrane ) that I must do this or pay the price later on :).

This time I am doing more than just reposting the text that’s been prepared for us (and if you want to see that, it’s here), I am reporting after 4 years that in 2011 I have had the conversations. And I’ve had them in part because of this campaign, in part because of Suze Orman ( @suzeormanshow ), who’s told her callers this year that they get an automatic “F” on their financial grade when they don’t prepare for those who come after them.

And….it’s not easy, starting with the conversation, and all the way through to execution. This conversation is co-mingled with the financial one, I don’t think they can be separated. The bummer is that once you have the conversation there is much work to do to document it. Some financial institutions make this process easy, many do not, it generates lots of paper. Paper that is not conveniently accessible, paper that’s hard to understand, hard to put on file with your health care provider.

However I did it. And I emerged with better knowledge of what those around me want, and documentation of what I knew in my head, but hadn’t codified. And a ton of dissatisfaction with the process and motivation to make it easier for others!

I think the current state of the process is simply a reflection of what people like Alex experienced in her own situation – when these things cannot or are not discussed during the process of care delivery, they haven’t been discussed during the design of the care delivery system, either. A search on iTunes for app to help out with this turned up nothing useful – interesting that out of 500,000 apps, not a single one about something this important. I also know from my electronic health record experience that this function is typically not as robust as ordering medicines, for example. Online, there’s just a jumble of PDF’s and word processing docs in arcane language…

Here’s the slide. I’m keeping this post on top throughout the weekend to stay in Alex’s good graces and to be rally-friendly. If you haven’t had the conversation, go ahead, have it. If you have had it, share your experience here or on the Engage With Grace site. If you have had it and wish you could improve the part that comes after the conversation as much as I do, let me know.


1 Comment

Ted Eytan, MD