Friday, February 8, 2013

Conversation Project

By:  Dr. Gregory W. Ayers, MD
Medical Director Comfort Care Hospice

 One of the most difficult things to see as a physician is when a family member has to make a decision and they tell me “I know what I would want, but I don’t know what my mamma would want.”  We plan for graduations, weddings, births and all other life events but we don’t prepare for or talk about death.  It’s so important for families to have this conversation at any age.

The Conversation Project is a unique program that was started to help people discuss their preferences for end-of-life care.  This non-profit group teamed up with the National Institute for Healthcare improvement to create a starter kit that is available free of charge at

 ·        70% of people in a recent survey indicated they don’t want to die in the hospital setting or long term care;
 ·        Studies show that about 70% of the population will end up dying in the hospital or in a long term care facility. 
 ·        There is a disconnect between what people say they want, and the type of care they will receive as the end of life draws near.
 ·        82% of people say it’s important to put their wishes in writing and only 23% have actually done so.
 ·        We need to do more to make sure patients have an opportunity to discuss their values and goals for end-of life care.


The Conversation Starter Kit is a booklet that encourages loved ones to sit down together and talk about their values and the role they want to play in deciding the care they receive. 

There are four steps:

 1.     Preparation – this explains the need for the conversation and asks participants to think about what they need in order to have this conversation with family members.
 2.   Asks participants what is important and provides questions with rating scales to help him/her determine where they stand on end-of-life issues.  For instance, one question asks participants to rate on a scale of 1-5 how much they want to know about a diagnosis.  If they rate it as a five, they want to know everything.  If they rate it as one, then they want to know only the basics.
 3.     The third step encourages participants to determine who they need to discuss their wishes and set up a time and place to talk about their wishes
 4.     The last step is encouraging people to translate those wishes into legal documents and provide them to their primary physician, hospital of choice and family members so the documents are easily accessible if the need arises.

Comfort Care Hospice is providing a printed version to the community for more information contact Comfort Care Hospice at 205-663-6887 or email

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