"It Depends" and why CaringEnd?

doctors family caregivers Aug 23, 2022

"It Depends"

Some time ago, I was caring for a 94-year-old gentleman. An active senior, he lived alone in his small home, doing most everything for himself. Basic self-care tasks like eating, bathing, grooming, and getting dressed were not obstacles. Except for shopping and housekeeping, but he managed his money, medications, and cooking.

One day, I made a visit with the goal of documenting his advance care plan. So, I asked him, “If your heart should suddenly stop beating, would you want everything done? 

After a thoughtful moment, he replied: “It depends.” 

There is no one-size-fits-all answer to this question. It is a personal one and varies from individual to individual. Even in the same individual, one’s answer to “Depends on what? “And “When is enough enough?” evolves as age and health change over time. My struggle with this question birthed an idea for the project I now call CaringEnd. 


Why I started...

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3 tips - You CAN overcome your patient's reluctance to have advance care planning conversations

doctors Jan 17, 2022

The challenge: 

Starting end-of-life advance care planning conversations with our patients can seem daunting. Tight, overbooked schedules, demanding workloads, and even lack of training are some of the barriers. 

Another barrier: our patients’ ambivalence - even reluctance - to have end-of-life advance care planning conversations. 

Interestingly, I’ve found that both doctors and patients alike confuse advance care planning conversations with delivering bad news conversations. 

Here are 3 tips to help.  


Tip #1: encourage patient readiness.

We clinicians can take comfort. Most of my patients were pleased, in hindsight, when I made the effort to discuss elements of their end-of-life advance care planning in a routine, supportive, and sensitive way.

Surprise: I discovered that this discussion itself encourages readiness and openness when handled in a supportive and sensitive way. 

For example, you notice Mr. Arnold’s...

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Talking about End-of-Life Care & Revitalizing Clinical Practice

doctors Mar 17, 2021

Vamshi Gunukula of DirectShifts, a physician staffing company, interviewed me on 3/4/21. We discuss a variety of issues that primary care doctors face, from end-of-life advance care planning to changing models of care, the role of healthcare informatics to thoughts about potential new opportunities.

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