Advance Care Planning isn't just, or even primarily, about writing down wishes for future healthcare. It's about clear communication amongst patients, family members, friends, and healthcare providers. It's about listening, asking pertinent questions, and respecting each other. It's about goals for living well during health and sickness. It's about what gives life meaning. It's even about communicating worries and preventing medical errors. It's not surprising then, that Advance Care Planning issues can crop up all over the place--sometimes in hotel shuttle buses and sometimes at fundraising dinners.
In my other life, I volunteer with Hope International Development Agency—a grassroots, non-profit organization that focuses on providing basic human necessities (i.e., clean water) for the neediest of the needy in the developing world. Surprisingly, two conversations from the recent round of fundraising dinners in Alberta, BC, and Ontario, actually had Advance Care Planning written all over them.
The Airport Shuttle
She and I were both on the hotel shuttle to the airport—both heading for Toronto; she to go back home, and me to organize a silent auction at two Ontario fundraising dinners. When she asked if this was my full time job, I explained that my day job was teaching communication skills to healthcare providers. Her face lit up, and so began an animated conversation. She works for an insurance company—one that specializes in insuring municipalities and towns. I explained how crucial good communication skills are for healthcare providers and how often a lack of communication skills results in less than optimal outcomes in the healthcare sector. This got her thinking about the situation in her own business. “Wow,” she remarked, “I never thought of communication being a safety issue before, but it really is. We need to hear more about this in our business.” I wonder what she’ll do with this epiphany.
The Fundraising Dinner
She and I were both at the same dinner table; as we chatted she asked me if I was employed by Hope International Development Agency. I explained that I volunteered with Hope, but had my own business teaching communication skills, specifically, skills in facilitating Advance Care Planning conversations, to healthcare providers. Her immediate response was, “I have some physicians who need to attend your classes…want to hear my latest experience?” She proceeded to tell me about her recent ophthalmologist visit. She explained that she had a rare, progressive muscle disease that called for her to see an ophthalmologist on a yearly basis. “I went for my routine exam,” she began, “and minutes into the visit the doctor told me I wouldn’t be able to drive anymore. The visit went on for several minutes, but I heard NOTHING after he told me I wouldn’t be able to drive. I was stunned. All I could do was think about how my daily activities would be curtailed by this restriction. I went home in a daze. A few days later, still upset, I went to see my family physician. She encouraged me to call the ophthalmologist’s office and make a “consultation” appointment—an appointment to discuss the driving restriction and the reasons for it. I never knew this was an option, but I quickly followed her instructions. I’m so glad I did. I explained to him how I had not processed any of his comments after he told me I would not be able to drive. He was immediately concerned and listened intently to what I had to say. ‘Look over at that eye chart,’ he said after I had fully expressed my concerns. ‘Read as many letters as you can.’ He then checked my chart and said, ‘You know what, I think you WILL be able to drive. We can put a special lens in your right eye, and, yes, you’ll be able to drive.’ I walked out of that office on a cloud. I don’t know why he didn’t figure this out during the previous exam, but right now I don’t care. I’m just thrilled that I’ll be able to drive for a while longer. What would have happened if I hadn’t gone back to him to talk about things?”
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