Lessons on living well, reflections on death, and holistic care.

Purpose 0:05 0
“One thing to get right out of the gates here is bodies die. Living things die.”

No comments yet.

View all comments (0)
Purpose 0:24 0
“By the way, the reality is palliative care is just good healthcare.”

No comments yet.

View all comments (0)
Mental health 0:34 0
“What they all seem to have in common is they regret not letting themselves feel artificially or accidentally putting a wedge between you and anything.”

No comments yet.

View all comments (0)
Mental health 1:06 0
“What about the role of forgiveness? I would say more commonly what I see people needing to learn how to do is forgive themselves.”

No comments yet.

View all comments (0)
Mental health 7:31 0
“I also felt really able to be there for others. You know I was 18 and the adults around me were as you can imagine all over the place.”

No comments yet.

View all comments (0)
Mental health 7:21 0
“I was very affected I was there was a lot of emotion I felt fear and um overwhelm but I also felt really able to be there for others.”

No comments yet.

View all comments (0)
Mental health 9:41 0
“that was a really big wakeup call to me. And for for people who aren't familiar with that type of injury I mean I've I've seen you without a shirt on I know what the the you know it's it's it's not like oh we just cut these things off and you'll be we'll be home Friday and we'll see you at clinic next week.”

No comments yet.

View all comments (0)
Disease prevention 13:19 0
“So on this podcast we talk a lot about causes of death right people who listen to me are very familiar with the four horsemen and we know about cardiovascular disease and we know about cancer and we know about neurodegenerative disease and we can talk forever about these things but we don't really talk about the very very end perhaps with the exception of a fatal myocardial infarction.”

No comments yet.

View all comments (0)
Nutrition 18:01 0
“An interest in food and fluid is a big one. So a body trying to die, a GI tract that's on its way to shutting down will stop sending hunger signals.”

No comments yet.

View all comments (0)
Gut health 18:50 0
“it will hurt if a gut is not able to process the food it sits in place and can cause pain”

No comments yet.

View all comments (0)
Hydration 18:55 0
“Same with fluids. If we're forcing fluid into a body that's trying to die, that fluid will pool and cause trouble.”

No comments yet.

View all comments (0)
Circadian rhythm 19:52 0
“the loss of circadian rhythm, the use of narcotics and other medications can easily induce delirium in a person who's otherwise not going to die.”

No comments yet.

View all comments (0)
Mental health 19:33 0
“So people often get really fuzzy in their thinking or all and delirium is very common.”

No comments yet.

View all comments (0)
Mental health 25:20 0
“I will say as a medical person I was taught that delirium is inherently a kind of suffering, that it's uncomfortable, that to be confused, to be disoriented is itself uncomfortable and it's certainly problematic for the loved ones.”

No comments yet.

View all comments (0)
Mental health 26:36 0
“I increasingly would not medicate a delirium unless I had a conversation... Would you like us to kind of air on the side of medicating that and help you sleep through it, you know, or talk to family about that?”

No comments yet.

View all comments (0)
Mental health 28:21 0
“I think suffering, I think an average human had a different relationship to the day-to-day suffering and pains that went with being alive.”

No comments yet.

View all comments (0)
Disease prevention 34:18 0
“You could be diagnosed with a very serious cancer that actually has pretty robust treatments and you could live for quite a long time, meaning many, many years.”

No comments yet.

View all comments (0)
Mental health 36:02 0
“And that is an inherently holistic question because it gets at their identity. It gets at their physiology. Possible as defined by them.”

No comments yet.

View all comments (0)
Disease prevention 1:04:45 0
“One thing your audience needs to appreciate and why advanced directives are so helpful for example is the system is what is it is by def the default modes of our health care system would be just do more stuff prop your body up anything to give you a pulse unless you've written or stated otherwise.”

No comments yet.

View all comments (0)
Mental health 1:06:36 0
“It's not a life anymore. And and and you would say well is there a chance that this person's going to recover well of course there's always a chance but how big does that chance need to be for the expected outcome to justify what you're doing.”

No comments yet.

View all comments (0)
Mental health 1:12:23 0
“what has this meant like what has this experience meant to her so far right like what is so let's say she says this has been the most jarring terrifying thing I have gone through in my life”

No comments yet.

View all comments (0)
Social connection 1:13:16 0
“so much about those initial encounters or meeting of somebody is about rapport building right you have to get into a back and forth so that they feel you as another person there that's curious about their experience”

No comments yet.

View all comments (0)
Mental health 1:14:13 0
“nobody's had the time to say how are you what does this mean to you are you know oh you're waking up at night what are you thinking about when you wake up at night what what is the biggest worry that this brings up for you”

No comments yet.

View all comments (0)
Mental health 1:19:38 0
“this is where our work at mental health I think folds in because the health system is not staffed or primed or any other number of adjectives you know to support people in the ongoing way that most would benefit from”

No comments yet.

View all comments (0)
Genetics 1:22:57 0
“let's say that this person for the sake of this case study watched their parent die of Alzheimer's disease and there's a strong hereditary component here”

No comments yet.

View all comments (0)
Mental health 1:24:01 0
“I am most worried that I'm not going to be able to care for myself, that the people I care about are going to need to take care of me and it's going to inconvenience them. And I'm not ready to lose my mind.”

No comments yet.

View all comments (0)
Mental health 1:24:36 0
“This is a person who is still working who is contributing who loves their life and they're basically mourning the loss of that.”

No comments yet.

View all comments (0)
Mental health 1:27:11 0
“You may ask no questions about the diagnosis. It may take five visits before you get to anything that for the reason you're supposedly there.”

No comments yet.

View all comments (0)
Social connection 1:30:16 0
“the unit of care is the patient and family”

No comments yet.

View all comments (0)
Social connection 1:32:44 0
“the number of times spouses adult children just are immediately brought to tears with the question how has this been for you because no one has asked them”

No comments yet.

View all comments (0)
Purpose 1:33:44 0
“probably 60% of our clients are the family members because there's just no place no one's asking about their experience”

No comments yet.

View all comments (0)
Purpose 1:34:49 0
“advanced directives is very important”

No comments yet.

View all comments (0)
Social connection 1:36:30 0
“I'm very honored to say the number of people that have asked me to be the decision maker for them... And I say the same thing to all of them which is it's an honor to do it but we have to sit and talk.”

No comments yet.

View all comments (0)
Social connection 1:37:07 0
“The job is for you to honor the other person's wishes. Speak on their behalf. So to do that well you have to know the person's wishes and that's not a couple of questions. That's a big old conversation.”

No comments yet.

View all comments (0)
Purpose 1:37:28 0
“You're setting a table that's comfortable. Often you're sitting, you're asking intimate questions. As providers you may be sharing intimate details too as part of a relational sort of set a table for in you know in intimate things to happen.”

No comments yet.

View all comments (0)
Purpose 1:39:27 0
“I think it's also like this is one of those places where you want to focus on the things that are important to you, the experiences that are central to good days to meaningful time.”

No comments yet.

View all comments (0)
Disease prevention 1:49:48 0
“I think one of the beautiful parts of our work is in the nature of people being linked to palliative care, hospice care there's some ability to comfort that.”

No comments yet.

View all comments (0)
Disease prevention 1:50:42 0
“I think we can say that no one in 2025 needs to die suffering. As long as you include the potential for sedation to be part of that, it may take so much narcotic to quell your pain or your shortness of breath.”

No comments yet.

View all comments (0)
Disease prevention 1:51:14 0
“Opioids are often one of the central medicines in managing the symptoms related to dying and related to serious illness at a certain point.”

No comments yet.

View all comments (0)
Substances 1:55:45 0
“We're going to be using them judiciously. A lot of people when they hear get the morphine, it's a there's a phrase like hang the morphine sometimes is a euphemism for essentially euthanizing a patient.”

No comments yet.

View all comments (0)
Mental health 1:56:35 0
“someone can have all of their symptoms pretty well managed and feel pretty comfortable physiologically and have an extraordinary amount of suffering.”

No comments yet.

View all comments (0)
Mental health 1:58:03 0
“It's when the noise and the volume of the pain often is turned down that we get to learn about the stories someone is telling or the things that are replaying in their heads about not getting to see their kids grow up or not getting to finish that piece of work that felt so important to them.”

No comments yet.

View all comments (0)
Mental health 2:03:23 0
“it's also very possible that people can have be having this incredible emotional and social and spiritual growth even as their body is in decline.”

No comments yet.

View all comments (0)
Mental health 2:04:48 0
“The sooner the better. And because one of the things you'll allow in is a a richer life right and a one of the reasons why we would encourage people to think about death earlier in life is not just sort of to avoid the um defaults of a medical system that doesn't think about these things.”

No comments yet.

View all comments (0)
Social connection 2:07:14 0
“is about connection right so and what does that mean like whether you are the person who's dying like your ability to connect to self to the environment to the people around you if there are other people there if you're a person around supporting like can you be connected and in contact with what's happening right it it when there's a lot of connection or connectivity in this time like the circumstances matter but a lot of different circumstances a lot of different story lines can actually feel quite um aliveening or even nourishing or um validating because it is you know it's being in touch with what is real”

No comments yet.

View all comments (0)
Social connection 1:29:19 0
“So if we work towards environments and um a focus on promoting the idea of connection I guess I just really believe that that that translates regardless of mental status or like mental clarity.”

No comments yet.

View all comments (0)
Social connection 2:10:34 0
“just a kindness of a person walking by just a little bit of eye contact little wink just a hey I see you see me just that infinite connect you just nothing maybe they hold the door open but just just a little connectivity and just the realization that it is an illusion to say you're alone.”

No comments yet.

View all comments (0)
Substances 2:11:42 0
“I think anecdotally I have seen psychedelic experiences be incredibly helpful to folks that have kind of run into a place in themselves where they don't have you know they've kind of just hit a wall in their own imagination in their own mind as to what this experience is or what it can be that there's just this kind of opening that can happen.”

No comments yet.

View all comments (0)
Purpose 1:36:48 0
“I just think that the commonality back to your question has something to do with not being quite true to themselves or not allowing a trying to keep something out of their experience and all the work they did.”

No comments yet.

View all comments (0)
Mental health 2:18:11 0
“Buddhism was sort of founded around this question and to give you a life of practice around meditation to how do you hold your mind so that you don't suffer unnecessarily so that you can be okay with the fact of your death.”

No comments yet.

View all comments (0)
Purpose 2:19:14 0
“Tomorrow is not promised to me. And if that is true, can I use that as this reminder that like this moment, the way that I speak to you, being tender when I do things out of my value system right, staying really connected to now right is the invitation that comes from or comes next to or has come for me in being so aware of mortality right.”

No comments yet.

View all comments (0)
Stress management 2:21:49 0
“some efforts there and let go of all the things you can't control And maybe in the middle identify that even though there are some huge things we can't control there is a lot we can influence”

No comments yet.

View all comments (0)
Mental health 2:22:45 0
“practice not being in control that will serve you very well as you head to your death”

No comments yet.

View all comments (0)
Purpose 2:22:39 0
“I think what we let go of is the other half of that message which is not oh don't give a [ __ ] about it because you can't control it like learn sit with all that you can't control”

No comments yet.

View all comments (0)
Hydration 1:49:01 0
“You're not making as much urine in part because you stopped drinking probably a few days ago because your body couldn't handle the fluids.”

No comments yet.

View all comments (0)
Mental health 1:51:52 0
“And if we can invite attention to everyone's experience and give permission to like you need to take a walk go take a walk. It may mean that they die when you're not in the room. And maybe that's okay.”

No comments yet.

View all comments (0)

Most important takeaways of the video

  1. Palliative care is emphasized as an integral part of quality healthcare, shifting the perception of it from a specialized service to standard practice.
  2. Common regrets near the end of life involve emotional suppression and disconnection, highlighting the importance of acknowledging and expressing feelings.
  3. Self-forgiveness is crucial for mental well-being, with an emphasis on the therapeutic benefits of forgiving oneself.
  4. Social connections play a significant role in enhancing the end-of-life experience, providing comfort and validation.
  5. Understanding and accepting the uncontrollable aspects of life can lead to a deeper sense of purpose and personal growth.

Overview

The detailed conversation covers various aspects of palliative care, mental health, disease prevention, and the importance of holistic treatment approaches. It emphasizes the inevitability of death, the role of palliative care as fundamental healthcare, and the psychological effects of medical conditions. Insights into how psychological states like forgiveness and emotional support play a crucial role in managing health treatments are also discussed.

Key Highlights

The discussion highlights several important themes: the natural decline in hunger and hydration near death, recognition of palliative care as a basic part of healthcare, and the critical role of mental health management in palliative contexts. The conversation also covers disease prevention, particularly focusing on the management of symptoms and advanced care planning to ensure patient care aligns with their wishes.

Mental Health Insights

Emotional health forms a significant part of the discussion, with multiple entries addressing how emotional suppression and a lack of self-forgiveness contribute to regret at life’s end. There’s considerable emphasis on understanding patients’ emotional and psychological states, which are often overshadowed by the focus on physical symptoms. The conversation also mentions how historical attitudes towards discomfort and suffering differ from modern perspectives, potentially affecting our handling of these experiences today.

The Role of Social Connections

Social connections are portrayed as imperative both in palliative care settings and broader healthcare practices. The narrative frequently touches upon the need for healthcare providers to engage with patients and their families meaningfully, ensuring emotional support is available to all involved. It also discusses the importance of advanced directives in healthcare, stressing clear communication about patient wishes for end-of-life care.

Futuristic Outlook and Ethical Considerations

There is a forward-looking stance on the capabilities of palliative care by 2025, predicting advancements in symptom management that prevent suffering at death. Ethical considerations in treatment, especially regarding the balance of life-sustaining interventions against quality of life, are debated, highlighting the ongoing challenges in healthcare decision-making processes.

Palliative Care and Disease Management

The effectiveness of palliative care in managing debilitating symptoms and ensuring quality of life is reiterated, with opioids mentioned as a central component of symptomatic treatment. Discussions extend beyond physical care to consider the psychological impacts of serious illnesses and the ways in which holistic care approaches can significantly benefit patient wellbeing.

Overall, the conversation encapsulates a comprehensive view on death, healthcare, and the nuances of managing terminal and chronic conditions with a patient-centered approach, advocating for greater integration of mental health considerations and bespoke patient care strategies.