Compassionately navigating end-of-life discussions with patients is something that many doctors haven’t yet mastered. All too often, a doctor may unintentionally leave a critical conversation unexplored, or encourage the patient to make a choice that doesn’t have their ultimate best interests at heart. This can create bad experiences for patients near the end of their life—something that Dr. Gawande hopes to change.
A deeply important and highly-sensitive discussion, speaking to your loved one about end-of-life issues is undoubtedly challenging. The documentary “Being Mortal” explores different families grappling with the same problem: tackling serious illnesses and different end-of-life options. In the film, writer and physician Dr. Atul Gawande delves into the obstacles that can arise when doctors try to present the best options for a patient. Underpinning the film is a message of hope, encouraging people to work actively towards identifying and communicating their wishes for end-of-life care.
Dr. Atul Gawande’s Personal Story Inspired the Film
Dr. Gawande notes that while many doctors (such as himself) believe they’re very good at handling these difficult conversations, the reality is that most are not. After exploring this issue more, he realized that he, himself, has at times failed to offer the necessary compassion or perspective when communicating end-of-life options to patients. Sadly, it was when his own elderly father was diagnosed with cancer that Dr. Gawande experienced firsthand the problems that poor end-of-life communication can cause.
In the film, he recounts the difficult experience he and his family had during this time. Dr. Gawande noticed that instead of trying to find the best choice for his father, the doctors were more inclined to suggest medical options that would likely drastically lower his father’s quality of life, or even shorten the amount of time he had left. That experience motivated Dr. Gawande to delve further into this problem—and even acknowledge his own shortcomings as a doctor to end-of-life patients.
How “Being Mortal” Tackles Complex End-of-Life Issues
The documentary makes it easy for the average person to understand the multi-layered complexities inherent in communicating about end-of-life issues. Dr. Gawande speaks with fellow doctors, end-of-life patients, and his own family members to investigate the issue from its many sides. Perhaps most affecting, though, is Dr. Gawande’s personal story, and how he made the film, in order to come to terms with his father’s end-of-life treatment.
Clocking in at a tight 54 minutes, the Frontline-produced documentary first aired on PBS last year. The film makes excellent use of Dr. Gawande’s professional insight as it tackles some of the most difficult aspects related to end-of-life discussions. Most notably, it investigates the reasons why doctors often push for more medical treatment—such as chemotherapy—rather than listening to a patient’s wishes for their remaining time. Instead of enduring more medical treatment, end-of-life patients may prefer to spend time with their families or refuse painful and draining treatments. Yet these patient priorities often remain unheard and unacknowledged.
The Main Event: Screening, Discussions, and Connection
Bay Area community members had a chance to see this impactful documentary when it screened at the Morgan Hill Community & Cultural Center on Thursday, October 20th, 2016. Located in close proximity to Institute on Aging’s Santa Clara office in Morgan Hill—which houses IOA’s Community Living Services in Santa Clara County—the center played host to a total of 130 community members who attended the event. Additional chairs were even brought in to accommodate the higher-than-anticipated turnout.
Before the screening, guests were encouraged to socialize and visit partners’ tables from 1 to 2pm; the main program was held from 2 to 4pm. The community-driven event also included facilitated discussions on many related topics: aging with dignity, advanced care planning, cultural differences, and the importance of communication regarding end-of-life values.
Of course, it wouldn’t have been possible without the hard work and collaboration between numerous local partners: Institute on Aging, City of Morgan Hill, County of Santa Clara Aging & Adult Services, Seasons Hospice & Palliative Care, and Kaiser Permanente South Bay all were instrumental in manifesting this vision into reality. Attendees enjoyed tasty refreshments courtesy of Seasons Hospice & Palliative Care, and Kaiser Permanente South Bay provided a sponsorship grant to Institute on Aging—a grant that enabled the production of not one but two “Being Mortal” events in the Bay Area.
Morgan Hill’s Age-Friendly Community
The Mayor of Morgan Hill, Steve Tate, was also on hand to offer inspiring welcoming statements. He took the opportunity to announce Morgan Hill’s newly-established status as an Age-Friendly City. Mayor Tate explained that events like this were very much in keeping with Morgan Hill’s intentions as an “age-friendly” community. He reminded the group that dying is another part of living, and prompted those in attendance to step out of their comfort zones and have conversations about it.
In an ongoing effort to achieve and maintain its age-friendly status, Morgan Hill has been focusing on creating an inclusive community. This includes ensuring that housing, transportation, and health services are accessible to older adults living there. They also work on establishing opportunities for older adults to participate fully in the community. As a county, Santa Clara has embraced an age-friendly initiative across the region, prioritizing a high quality of life for older adults.
More in-depth discussions took place after the film’s screening to stimulate questions and conversations. These were led and moderated by Institute on Aging’s Dr. Patrick Arbore, EdD. Afterward, Dr. Arbore gave a lecture and presentation that urged everyone at the event to meet and talk with their tablemates about the impact the film had on them. The ultimate goal put forth by both the film and Dr. Arbore was clear—we must encourage people to have more open conversations about end-of-life issues.
Educational community events like this are so important: they provide a safe space to learn about difficult topics, ask questions, and communicate with others in similar situations. And this in itself can provide both you and your aging loved one with critical information and emotional reassurance to help you move forward with a sense of empowerment.
If you’re unsure how to talk with your aging loved one about end-of-life issues, Institute on Aging offers a variety of programs, services, and online resources. Reach out today to learn more.