While medical science had made some miraculous advances so far it has not made anyone immortal. While most recognize the need for end-of-life planning, less than half actually do it, according to The Conversation Project, a national organization dedicated to helping people talk about their wishes for end-of-life care.
The Regional Steering Committee of The Conversation Project is working to improve that statistic in the Northwest, and grew out of former Boston Globe columnist and Conversation Project founder Ellen Goodman’s visit to Portland last fall.
“When I turned 60, I went from being a working mother to a working daughter,” Goodman shared. In her role as the “designated daughter,” she was blindsided by the cascading, time-sensitive, difficult decisions that often need to be made in the crucible of the ICU or an emergency room. “We need to change the culture,” said Goodman so the wishes of the dying are known and respected within the family and within the medical system.
Choosing Options, Honoring Options (COHO) is taking on Goodman’s challenge in southern Oregon and has found a particularly successful way of facilitating end-of-life conversations and advance care planning through the talents of its vibrant theatre community. In addition to its speakers’ bureau and the Conversation Project’s toolkit, it’s produced two plays written and performed by members of Ashland’s TV, film and Oregon Shakespeare Festival community, and reported that 70 percent of its audiences indicated they would complete or revise their advance directives or POLSTs.
“It’s hard to sell death,” said Adie Goldberg, a psychiatric social worker in palliative care for Asante Physician Partners. Personal stories and the theatre experience are far more effective than a power-point presentation in prompting patients and their families to discuss and document end-of-life wishes.
Playwright Peter Quince said even though people resist talking about death there’s a “thirst” to hear about it. “The medical system has its own protocols and it’s intimidating to come into this process. The doctors seem so sure and suddenly a month has gone by and one thing leads to another.” In his play, the patient has had CPR and is intubated with a feeding tube while the medical system fights with death – against the unconscious patient’s wishes.
“What matters most is rarely medical,’ said Torri Fields, director of palliative care at Cambia Health Solutions. “But physicians can only do what is medical.”
“This play actually prepared me for my dad’s death,” said Laura Derocher, the actress who played the daughter in Who’s Death Is It Anyway for COHO’s performance in Portland on May 8, exactly six days after her own father’s death. “I’m more at peace than I was when we debuted (the play) March 20. I had a beautiful two weeks with him.”
Image for this story by Julián Rodriguez Orihuela (CC BY-NC-SA 2.0) via Flickr.
