Christian Sinclair, MD, FAAHPMNational Hospice Medical DirectorGentiva Hospice

Before I Die walls

Say It – Lien Foundation

Before I Die walls

Before I Die walls

Before I Die walls

Before I Die walls

Before I Die walls

Before I Die walls

Before I Die walls

Obitcheery

QR Memorials

Caring Conversations – Center for Practical Bioethics

Caring Conversations – Center for Practical Bioethics

Caring Conversations – Center for Practical Bioethics

Caring Conversations – Center for Practical Bioethics

Caring Conversations – Center for Practical Bioethics

Caring Conversations – Center for Practical Bioethics

National Healthcare Decisions Day - Facebook Page

National Healthcare Decisions Day - Facebook Page

National Healthcare Decisions Day - Facebook Page

National Healthcare Decisions Day - Facebook Page

National Healthcare Decisions Day - Facebook Page

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Patrick et al. Ann Intern Med 1997;127:509-17.

Prefer CPR if…

Patrick et al. Ann Intern Med 1997;127:509-17.

Advance Directives – Medical• Preferences and Goals– Living Will– Five Wishes– Caring Conversations

• Surrogate Decision Maker– HC DPOA– Next of Kin (default)

• Physician’s Orders– Do Not Attempt Resuscitation– TPOPP

TPOPP

• Transportable Physician Orders for Patient Preference

• POLST Paradigm• Pilot Clinic in Topeka• Beginning roll out in Kansas/Missouri• Sandy Silva – Center for Practical Bioethics

Center to Advance Palliative Care

Challenging Conversations

• Infinite number of what if scenarios• Ask about values• Listen for the distractions• Listen for the humor• Ask about a good death• Ask about a bad death• What is important to you• Who is important to you?

I Love You Forgiveness

Thank You Good-Bye

The Four Things That Matter Most – Ira Byock, MD

Resources

• A Good Death photos essay – New York Times• Death Café• Death Over Dinner• Before I Die walls• Obitcheery• QR Memorial• The Conversation Project• National Health Care Decisions Day – April 16th• Center to Advance Palliative Care

Good Reads

• The Four Things That Matter Most – Ira Byock• The Signal and The Noise: Why some

predictions fail and others don’t – Nate Silver• AHRQ – Advance Care Planning• Patrick et al. Validation of preferences for life-

sustaining treatment: implications for advance care planning. Ann Intern Med 1997;127:509-17.