Engage with Grace

Thanksgiving is a time we traditionally gather together with family and friends to express our gratitude for being able to share food and companionship with one another. It can also be a wonderful opportunity to share with loved ones our most personal wishes for what we hold important to us at the end of life if we were unable to speak for ourselves. I was pleased to be invited to play a part in spreading the word on the Engage with Grace: One Slide Project by Paul Levy, CEO and president of Beth Israel Deaconess Medical Center in Boston. The goal is to begin this important conversation with loved ones before the need arises, so you can best carry out their wishes and choices if they cannot speak for themselves. From Nov 26-Nov 30, health bloggers across the globe will be sending out the same message to their readers, hoping that we can help you find the words to begin this compassionate conversation with your friends and family.

We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don't express our intent or tell our loved ones about it.

This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die in hospital. More than 80% of Californians say their loved ones “know exactly” or have a “good idea” of what their wishes would be if they were in a persistent coma, but only 50% say they've talked to them about their preferences.

But our end of life experiences are about a lot more than statistics. They’re about all of us. So the first thing we need to do is start talking.

Engage With Grace: The One Slide Project was designed with one simple goal: to help get the conversation about end of life experience started. The idea is simple: Create a tool to help get people talking. One Slide, with just five questions on it. Five questions designed to help get us talking with each other, with our loved ones, about our preferences. And we’re asking people to share this One Slide – wherever and whenever they can…at a presentation, at dinner, at their book club. Just One Slide, just five questions.

Lets start a global discussion that, until now, most of us haven’t had.

Here is what we are asking you: Download The One Slide and share it at any opportunity – with colleagues, family, friends. Think of the slide as currency and donate just two minutes whenever you can. Commit to being able to answer these five questions about end of life experience for yourself, and for your loved ones. Then commit to helping others do the same. Get this conversation started.

Let's start a viral movement driven by the change we as individuals can effect...and the incredibly positive impact we could have collectively. Help ensure that all of us - and the people we care for - can end our lives in the same purposeful way we live them.

Just One Slide, just one goal. Think of the enormous difference we can make together.

(To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team)

Happy Thanksgiving and may your Thanksgiving table be filled with companionship, compassion and conversation.

Putting the Patient First

As much as I believe we currently have a very broken system of health care in this country that is in urgent need of healing; when I see an organization that is doing right by the patient and families it serves, I readily applaud their success. Such is the case with Beth Israel Deaconess Medical Center (BIDMC) in Boston. While not part of the mega-Partners Healthcare group in the Boston area, they have been an institution at the fore of patient centered care, being one of the first hospitals in the country to institute primary care nursing over 30 years ago. I regularly follow the blog written by the CEO of BIDMC, Paul Levy. Through his blog, Running a Hospital, he has added transparency, humanness and compassion to the commonly hidden world of hospital administration. He has also helped to create a culture of cooperation and patient centered care among hospital staff that is truly remarkable. This culture of cooperation is evident by the following letter from a patient Paul Levy posted on his blog:

"As far as I'm concerned, you can take all those posted quality metrics and throw them out the window when you get a letter like this one that I received from a patient:

BIDMC is a special place. The nursing care deflates your stress about being
in the hospital. The doctor's talent makes you believe you have the best
possible care. The atmosphere makes you feel that people like their jobs and
feel invested in them, so you feel that everybody is paying attention, whether
they are cleaners, food service, transport, department heads, trustees.I
especially noticed the employees' investment in their jobs. (NURSE: "Doctor, I
noticed you are testing Ms. X for TB. If we believe she might have TB, should we
institute those protocols now?" TRANSPORT: "The nurses are really busy. I'll
reconnect your oxygen so you can go back to bed and I'll tell them that I did."
NURSE: Let's not wait for the bed to be changed. I want it to be dry for you
when you have these fevers." She changed the bed and me three times that
night.)Symbol of cooperation regardless of rank or function: Nobody left my room
without taking my meal tray with them.

Posted by Paul Levy at 11/20/2008 10:28:00 AM"

Wow!!!!! All I can say is kudos to Paul Levy and the staff at BIDMC for creating and maintaining a culture of cooperation and compassion and showing us that it is possible.

Road to Hope

"Hope is like a road in the country; there was never a road, but when many
people walk on it, the road comes into existence." Lin Yutang 1895-1976

As I came across this quote, I immediately thought of the monumental election on November 4 in which we have just participated. With any change there can be natural resistance and fear of the unknown, but this can also be coupled with unexpected opportunity. No matter if you aligned yourself "Blue" or "Red" during the past year, let us come together in this historic time and build a road of hope together, by walking side by side until the road comes into existence. I wish you hope, healing and gratitude during this month of Thanksgiving.