By Steve Moran
Once in awhile when I write an article it ends up going someplace other than where I thought it was going to go. I even had to go back and make a change.
My original title was this:
“Atul Gawande Missed the Mark at LeadingAge”
The reason for the original title and premise behind the title was that as Gawande talked about his family's personal experience with assisted living, he treated as revolutionary things that great senior living communities have been doing for years . . . like allowing residents to get up when they wanted to.
This perception was discouraging for two reasons:
He was paid big bucks to do the speech and I felt he should have done a bit more homework. Though I am willing to acknowledge he might have talked to the wrong people.
He represents the most enlightened of the physician community in the whole of the country and if his perceptions of senior living are so off the mark, it makes me believe the average working-every-day-in-the-trenches physician has no idea what senior living is really like and what it can do for their aging patients.
I went back to review my notes before writing this article and realized that to put all my emphasis on where he missed the mark would leave some really important stuff on the table. It wouldn’t have been fair to him and it wouldn’t have been fair to readers.
Gawande started his presentation by making the point that over the last time period . . . maybe forever . . . medical sciences have been completely focused on helping people to live longer by curing and preventing disease. While not denying the importance of living longer, it ignores an important reality:
People have in their lives priorities that go beyond just living longer.
This is true at just about any age for most people, at least in North America. We celebrate and admire risk takers. We often eat for pleasure not for health. As older people age, they watch how their peers exit this world and begin to realize that there are things worse than dying.
The Big Question
He suggests that rarely do we ask seniors this question: “What are your big wishes before you die?” I sort of like his question and sort of not. I prefer, this . . .
What is on your bucket list in the time you have left?
The reason for the twist is that when you ask about big wishes, it implies just one more big event or big thing off a “pick-list” and that seems way too limiting. I would like to suggest that every resident, even the ones who are on hospice, have legitimate bucket lists that are worth talking about and trying to make happen.
We do it all the time for dying children, like Daniel Fleetwood who wanted to see the new Star Wars movie before he died. People made it happen and he passed a few days later.
We need to be asking great questions, the right questions, the important questions. We need to make those bucket list items happen. Not only will it be great for both residents -- obviously -- and families, but it will also add purpose and meaning to the lives of team members.
The only difficult part is asking that question.
If you ask those questions, how do you go about it and how does it work in your communities?