Age Old Questions: The Aging Parents Podcast
A podcast that explores the challenges of supporting aging parents with wisdom, humor, and honesty.
Navigating the role of supporting an aging parent can leave you feeling frustrated, guilty, worried, and alone. I'm here to provide guidance, interview experts, and share stories from people just like you so you'll feel more connected, prepared, and less stressed. We have big complicated lives to live, and this is part of the whole thing. I want to empower and inspire you to enjoy, to laugh, to ponder, to grieve and to really engage in this part of life. - Ellen.
Ellen Koebel is a physical therapist who works in the homes of older adults. She has helped hundreds of families navigate the practical and emotional challenges of aging and illness.
Age Old Questions: The Aging Parents Podcast
02. Palliative Care & How to make medical decisions
Dr. Matthew Tyler joins me to answer questions about what palliative care is and why it might be right for your parent. He also gives some practical tips about how to start conversations with aging parents about their future needs, and how to make medical decisions for your parent if they aren't able to make decisions for themselves.
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Get the show notes and episode transcripts here https://www.ageoldquestions.org/post/palliativecare
Find palliative care near you https://getpalliativecare.org/
Check out Dr. Tyler's YouTube channel
https://www.youtube.com/@howtotrainyourdoctor/featured
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Visit the website: ageoldquestions.org
I think of myself a lot similar to a travel guide. You've got this illness and you're on a journey and we're there to help guide you through it, help you understand the various landmarks and figure out where your turnoff points are to make sure that you continue getting where you're hoping to go.
SPEAKER_02:Hello, and thank you for joining me today. This is Age Old Questions, the Aging Parents Podcast. Here we talk about everything involved in supporting aging parents. I I'm Ellen Coble, and in today's episode, we're talking about palliative care. Have you heard about palliative care, but you're not sure what it is or how to pronounce it? Well, you're not alone. Today, I talk with Dr. Matt Tyler, and he explains that palliative care is often misunderstood, even by people in the medical field. Matt is a palliative care doctor in the Chicago area, and he also has a YouTube channel called How to Train Your Doctor. to help educate patients and their families about how to navigate the medical system. In this episode, we talk about what palliative care is and who can benefit from it. Matt also talks about how to start conversations with your parents now about what sort of treatment they might want if they end up with a serious illness down the road. And he gives some great insight into how to go about making medical decisions for your parents if they're not able to make those decisions for themselves. I I think you'll find him to be knowledgeable and insightful and also wise and compassionate. I had a great time chatting with him and I hope you'll enjoy our conversation. Thank you very much, Matt Tyler, for being with us today, palliative care doctor. Go ahead and introduce yourself a little bit. Tell us how you got into palliative care. Oh,
SPEAKER_00:yeah, great. Excited to be here. Thanks for having me on here. So I came to be a palliative care doctor by way of internal medicine. So I fairly early on in residency realized that palliative care was where the real conversations were happening I think a lot of us that go into these primary care specialties, we do that because we want to make meaningful connections with patients. And I came of age in training around the time when that got harder to do as a primary care doctor with scheduling demands and everything else on the admin side that's just made it harder to sit down and have connections with patients. I found that on my palliative care rotation as a resident, this was the time where we could really sit down and talk to people about what matters most with them. And that was intern year. And I just clicked from there. And I said, yeah, this is this is what I want to do.
SPEAKER_02:Yeah. Actually, I feel like I had a similar experience. I did my final physical therapy internship in home health and just thought, oh, my gosh, this is like where people actually live. This is where you can make the most amount of difference. And you really are seeing seeing people as they are. And I just think it makes a you're exactly right. Like the real conversations.
SPEAKER_01:Yeah.
SPEAKER_02:Yeah. Well, so I think there's a lot of misconceptions or maybe confusion about palliative care and what it is. And I know that when my patients find out they've got a referral to palliative care, sometimes they don't know what it is or they are offended that their doctor thinks, you know, they're not going to live much longer. They've got a lot of questions and they don't they just don't quite know what it is. So tell us about what what palliative care is.
SPEAKER_00:Yeah, it's funny too, the way you set up that question, because I have found that what you said is true. Most people who don't come from a medical background just straight up don't know what palliative care is. So if I passed some random stranger on the sidewalk and asked them, they would just tell me, I don't know. I have no idea what you're talking about, what palliative care is. Whereas most doctors think they know what palliative care is and can confidently answer the question, what is palliative care? The problem is their answer is usually wrong.
SPEAKER_01:Uh-huh.
SPEAKER_00:And where I find most of the apprehension from patients and families comes from is from how clinicians incorrectly describe palliative care to them. And the research actually backs us up. There have been a couple of surveys across the past decade or so that have survey studies where they've asked patients and families out in the community what their understanding of palliative care is. And we have not done a great job as a field with that messaging. And the needle really hasn't moved all that much towards the general public's understanding of palliative care.
UNKNOWN:Thank you.
SPEAKER_00:Whereas more docs have become comfortable with it, just with the wrong version of it. So to get to the actual question, what is palliative care? Really, at the end of the day, palliative care is support for people living with a serious illness. And the focus of that support is on improving and maintaining quality of life for both the patient living with serious illness and their family and caregivers supporting them. And the great thing about palliative care is that it's multidisciplinary. So you're team may consist of docs, nurses, social workers, physical therapists, all working to better understand what matters most to you and making what matters most to you their priority.
SPEAKER_02:Excellent. Good. I've been describing it correctly then. A plus. We do have, we've got palliative care nurses on our home health team. So their perspective, I find really useful in approaching those, the kind of goals and making goals that are more based on the patient instead of maybe than the medical system. We like to make these goals about meeting these tests and making this much percent better. And I just don't know how meaningful that really is for our actual patients.
SPEAKER_00:Yeah, it really is a very collaborative approach, not just with the patient's other clinicians and providers, but with the patient and their family themselves to make sure that we are all working towards the same goal, as you said. And I think especially with serious illness, it's easy to get swept away in the medical system after a serious diagnosis, being told you need to see this doc and this doc and do this test and that test and try this treatment. And we don't often stop and talk about, you know, why are we doing all these things? There's generally this implicit assumption that it's to live as long as possible, but most people have other things they want to do too besides just living as long as possible. They want to feel as good as they can for as long as they can too and spend time with friends and family and do things with that time, not just exist. I think that's really where palliative care comes in is to talk about why are we doing all these things to make sure that we don't lose sight of that for the the individual.
SPEAKER_02:Yeah. You remind me, you're just reminding me of a story of my grandma. Um, she's been gone for many years now, but, um, getting swept up into the medical system where she was having trouble with something. She had been having some trouble for a while, but went to the ER and they were listing all of the different tests that they were going to do next and the different treatment options. And, um, apparently she kind of said behind her hand to, to my dad, um, they don't do dying here as if to say like, Oh, I don't know. I don't know how necessary all of this is. She, she knew it was right around the corner. Um, but it's not really, I don't know. I think it's not something that as medical professionals were really, you know, comfortable with that being part of the part of the process. We've got all our tools are like getting better, um, solving the next problem, the next layer of treatment. And, It's hard to take a step back and just wonder what is really appropriate and what's not.
SPEAKER_00:Yeah. And we could talk all day long about why the medical culture is what it is. Speaking of getting swept away.
SPEAKER_01:Yeah.
SPEAKER_00:Yeah. But for sure, it's at some point you need to pause and ask, you know, why? Why are we doing what we're doing and what are we hoping to achieve with these treatments and tests that we're doing?
SPEAKER_02:So then how do you help patients and families navigate that when they're starting to get swept up? How does palliative care and what you do create something maybe more meaningful?
SPEAKER_00:Yeah. I think of myself a lot similar to a travel guide. You've got this illness and you're on a journey and we're there to help guide you through it, help you understand the various landmarks and figure out Like where your turnoff points are to make sure that you continue getting where you're hoping to go. So really the beginning of that journey is kind of, if you think of it, you're at the mall with the big map and it says, you are here. Really the beginning of my relationship with a patient and their family is understanding where is here? Where are we right now? And that is often the hardest part of the conversation because that often involves breaking bad news in some way since not everyone Every doc is super great at delivering bad news. We're not universally trained in how to do that in a way that the patients can understand what we're saying. So the beginning of the relationship is kind of getting a sense of, hey, like, what have the other docs told you was going on? Like, what's your understanding of where we're at right now and what options you have moving forward? And really from there, kind of figure out where are the big gaps in their knowledge that we need to address before we're really going to move forward from here.
SPEAKER_02:So tell me a bit about what sort of patients do you see? Kind of what's your day-to-day? I'm not sure. Is there a typical day?
SPEAKER_00:Probably typical means something different to me than it does to most people. So to clarify who I see and where I see them, I do a little bit of everything. So I do most of my work in a hospital setting. So I see most of my patients have been hospitalized. Although I see patients in clinic, it over at our cancer treatment center. I also work on a home-based palliative care team where I advise a panel of nurse practitioners on how to take care of folks at home. And I do some hospice work as well. So I kind of run the whole gamut of work here. So most of the patients that I see are sick enough to need to be in the hospital, either with a severe infection or a very end-stage progression of a disease like advanced dementia. late-stage cancer, late-stage heart failure, things where it's getting harder to maintain their health with just the typical medications you would be prescribed to take at home.
SPEAKER_02:Do you ever feel like you get patients a little bit too late? Like wondering if you...
SPEAKER_00:I thought you were going to say too early. Never too late. And I think this really gets back to one of the biggest misconception of palliative care is that it's some sort of either or thing. Like you get your treatments or you get palliative care. But really palliative care is extra support for people no matter how old you are and no matter where you are in your illness, no matter what stage of illness you're at. If that illness is impacting your quality of life, you qualify for palliative care. That's just supplemental an extra layer of support for you and your family. So for sure, I see plenty of patients too late in that they've had serious compromises to their quality of life for days, weeks, months, years. And they were led to believe that palliative care was a lifestyle choice of some sort where, yeah, you can get palliative care and focus on your quality of life, but you have to give up your treatment. And that's really, I mean, it's more of kind of what hospice is about, but not so much palliative care or not at all palliative care for that
SPEAKER_02:matter. Yeah. So still can completely keep going on. with the treatments that you are wanting to get, but just an extra layer of support. Yeah.
SPEAKER_00:Yeah. And case in point for the folks that we're seeing with our oncology colleagues where they're getting treatment for cancer while getting support for their quality of life and symptom management through our team.
SPEAKER_02:Yeah. I guess it seems like, again, I could also talk too long about maybe some of the medical system, but it just seems like this makes sense to be part of all medical treatment instead of a separate, you know, kind of a separate ideology. But then I know that there's also kind of specific treatment that palliative care provides. So what sort of things are you providing for patients? What's involved in the actual treatment?
SPEAKER_00:Yeah, so in terms of the support we provide for folks' quality of life, I think the two big buckets of treatment we provide are symptom management, so helping out with making pain more tolerable, helping out with things like shortness of breath, fatigue, low appetite, the stuff that comes with a serious illness. We're the experts in symptom management in that regard. So we can help with some very concrete stuff like that. And the other big bucket of treatment we provide is what I would call helping with planning. So whether that is planning who your backup decision maker would be when you got too sick to talk to the doctors about your wishes directly, or just looking for some anticipatory guidance about what what to expect as your illness progresses. We kind of help lay out plans in a way that provides folks just a little bit more peace of mind knowing that there is a
SPEAKER_02:plan. And just a little bit of guidance, just like you said, a tour guide. Yeah, I like that. I like that analogy. All right. So I know you have a YouTube channel that you've been building, which I really appreciate. And you've got a video on there about palliative care, how to find it, how to get connected with this other layer of support. But if there's people that feel like this really fits a family member How do they go about, who do they talk to and how do they go about finding palliative care where they are?
SPEAKER_00:Yeah, well, thank you for asking because there's a bit of pragmatics involved in actually connecting with folks too. So to get connected with palliative care, we take care of folks in three main settings, as I alluded to it, in the hospital, in clinics, and at home. And where I would go first, if you're looking to connect with a palliative care team, would be this great website called getpalliativecare.org. And it's helpful because it will describe palliative care in more detail and hopefully corroborate what I've been saying here. But it's also got this palliative care provider database where you can plug in your zip code and the specific location of palliative care you're looking for between hospital, clinic and home. And it'll tell you what's available in your area. And this is going to vary region to region, you know, state by state. So I think this is a great place to start, though, if you're finding well, if you're not finding anything that looks like a good fit for you based on what that database shows up. I would also cross check that with your insurance carriers database as well. And you can go through the same thing, whether that's United or Blue Cross Blue Shield. They generally have a find a provider database where you can type in the specialty of a provider you're looking for, palliative care in this case, and your zip code, and they can show you what's in your area as well. And I've done both to see how good the overlap is in my area in Chicagoland. And there's overlap, but I definitely got different results in each of them. So I strongly recommend you do the same and check both databases to see what's most convenient for you. All
SPEAKER_02:right. Excellent. One of the other videos that you have that I found really useful was about making medical decisions for other people. So I think especially when you've got an aging parent, all of a sudden you're thrown into this role that maybe you were never expecting of making these important decisions. You're not sure if you're even supposed to be the one making these decisions. It's kind of unclear who's in charge. But when someone does get put in that position, maybe over a couple of years or maybe really suddenly, what sort of advice do you have for them? you know, just having a little bit of confidence and stepping into an area that feels brand new and, you know, just hard to know what decisions to make.
SPEAKER_00:Yeah. Oh, that is so stressful being in that caregiver position, especially for an aging parent, knowing that not every parent comes to their child with their exact wishes spelled out. And where I often meet the children of folks in the hospital is in the hospital where something has happened and the ship has sort of sailed on doing this in advance. So what I would say to folks listening to this would be, if you can start these conversations before there's a crisis, that can go a really long way towards providing a bit of peace of mind with whatever decision you do have to make at some point. And of course, the problem is you can never predict the exact decisions you're going to be asked to make in advance. And where I find... efforts to be best spent is just trying to engage your folks in a conversation period about what matters to them the most, what living means to them. And that tends to be a more helpful guide than trying to hash out, oh, would you ever want to be on a ventilator? If so, for how long? What about antibiotics through IV or oral? And for how long? It's just so impossible to predict these things in advance. I think where I see the children of aging parents succeed most is when they've had general conversations about their parents' quality of life and really what living would look like to them. And when it comes time to make a decision, I would press the clinicians for what the pathway of this decision would look like. So for example, a common thing that comes up with aging parents is advancing dementia. And at some point, someone listening to this will probably be dealing with a clinician who's asking them about a feeding tube for mom or for dad in the setting of advanced dementia. And I think the mistake here is to ask, do you want a feeding tube or not? But really focus on what would that look like? What would it mean to have, have a feeding tube. And could you, could you go home with that? Or would you be on a pathway towards a nursing home for the rest of your life? Could you ever eat the foods that you find enjoyable? Or is this sort of make a statement that we are no longer allowing mom or dad to eat period because we're trying to just push artificial nutrition and, and think about what your, what your parent would say about that. What, what would they say about this decision and what that kind of living would look like to them? And I really, really do like to focus on what a parent would say about a decision, not what they would want. Because a lot of these decisions are based on thought process. And docs, especially, try to push a decision. And they'll ask things like, what would your mom or dad want? And that's very outcome focused. That's very decision focused. And what you really need to know is why. Why would they choose what they're choosing? And you really can't skip that part. So what I What I will ask families who are making decisions for someone else is based on the context of what we've been talking about, again, where we are on the map, what would your parents say about their situation? What would they say is most important to them now? What would their priorities be? I think that's a good starting point. And from there, I often frame decisions in terms of trade-offs. So if it's about a feeding tube, for example, what are we giving up by doing this feeding tube? And for a lot of folks, it tends to be the joy of eating whatever food they want by mouth, the joy of taste, the sensation of taste, that very human experience. Or some decisions may lead them on a pathway to living in a nursing home. And understanding decisions don't happen in a vacuum, I think, is a good first step towards this as well.
SPEAKER_02:Yeah, I love that advice because I think the what would you want question is, Like you wouldn't want to be in that situation at all.
SPEAKER_00:Exactly. Exactly. And that, that is by far what, when docs ask caregivers and children of their patients, you know, what would they want? They all said that they want to get better. They want to live because of course we all do. We want to feel as good as we can for as long as we can. That's just sort of the human existence. And, and, We skip the part where we say why that's not possible anymore. We skip that context. We skip showing folks where they are on the map and understanding that there are priorities to make here. And when we skip that, the obvious answer is, yeah, they want to get better. They want to live. Why would you say anything else?
SPEAKER_02:Yeah. Yeah, I like the idea of... kind of saying, what are the realistic options here? Do you want to go down this realistic option of adding a little bit more support, maybe doing a feeding tube? Maybe this gets you someplace where you want to go. Or what does a living situation look like after putting this in place? It's much more meaningful than a what do you want question.
SPEAKER_00:And I think for folks listening that are in a situation like this with their parents I mean, absolutely ask for the support of a palliative care team because they can help you. They can be your sounding board. You can kind of think through questions that really matter in a situation like this beyond the immediate clinical decision to make. And I think we just have a different way of talking than most clinicians do. But I think ultimately our goal is to help people feel that the decision they're making is the right one. And I don't say feel good about decisions because there are going to be scenarios where you just, all the options are bad and you're not going to feel good about a decision. But hopefully we get to a point where you feel that the choice you're making is the right one for the person you're making decisions for.
SPEAKER_02:Um, how about if you've got a parent who can make some of those decisions, but they're still in a tough situation, um, but maybe not, you know, not dealing with dementia, how can, uh, adult child kind of help them talk through that process, um, or be, be part of that, that sounding board?
SPEAKER_00:Yeah, I think in this case, I would, I would come to the parent and say, can we, Can we just carve out some time to talk about the future and how we can best take care of you when things start to change down the road and get a sense of the parents' willingness to engage in that? And I think that's a good starting question because the folks that get immediate resistance, you'll have to change your tactic. And for some parents, they're happy to do it. They were just sort of waiting for that moment. I think these conversations, everyone's always waiting for someone else to bring it up and So no one brings it up. And I see this a lot with parents and kids, especially as children become adults living their own lives now. Both sides want to protect each other. Like parents don't stop being parents. Parents are always trying to protect their kids, regardless of how frail and sick the parent is. They don't stop trying to protect their kids. And as their bodies change and as their health deteriorates, they tend to avoid these conversations. because they don't want to burden their kids. They don't want them to worry. Meanwhile, the children are worrying because of course they're worrying. They can see their parents changing and they're trying to protect them too because now they feel this caregiver protector role. Because oftentimes at this point, those kids have their own kids and they're sort of living this dual identity of both child and parent at the same time. So I think there's often this sort of like treaty of silence, although not so much a treaty, but just a tacit agreement of silence. silence. And so just bringing it up. And I think, you know, with that idea in mind of everyone's trying to protect each other, offering that this would help you to say, you know, mom, dad, it would really bring me a lot of peace of mind to talk about the future and how to best take care of you when things change. Could we just sit down and hammer a few things out? I think coming, just kind of naming that, how that would help you and how that would help them still be a protector and a guardian. By saying how this would help you, I think it often unlock the initial first steps of the conversation.
SPEAKER_02:I think that, yeah, I love that.
SPEAKER_00:I think making it very clear that you're already worrying. Say like, I'm worrying now. I'm worried about you. I want to make sure that we have some things sorted out. So when things change, we know what to do. We know how to best honor your wishes and best take care of you. And that can really open up the doors to a conversation about what's most important to them. And as things change, what would their priorities be? So at least give a general guide on how to frame some decisions they may have to make down the road to feel like they did, you know, that they're going to do what's right.
SPEAKER_02:Yeah. Kind of putting the whole family on the same team, figuring out how to make those decisions together.
SPEAKER_00:Yeah. And I, and I think what I would add to that is if you've got a parent who's just super not into it and that, and that will happen, it happens. I would at least try to get a clear sense of who would make decisions for this person. If they did lose the ability to state their own wishes down the road to a medical team, especially. So this would just be trying to line up even a healthcare power of attorney. And this is especially important for parents who have multiple children who, depending on the state you live in, a surrogate law would come into place here. Individual states will have sort of what they call a surrogacy hierarchy, where if there's no guardianship paperwork in place, if there's no healthcare power of attorney paperwork in place, there's sort of a default hierarchy of who's in charge now. And it starts with the spouse, but for aging parents, there may not be a spouse at that point. And oftentimes we look to the children to make decisions. And if there are multiple kids, then they all technically have equal say in the decisions that are made. And if you have a great relationship with your siblings, then awesome. That's not a super big deal. But if you don't, then it may be a big deal and it may avoid a lot of conflict, if not all of it, by having a clear documentation who is in charge for mom or dad if they can't make their own decisions and and that choice can only come from the parent they have to sign their own paperwork this is not something that you can do after the fact so if you if you've got a parent who is able to state their wishes now having a clear proxy medical decision maker through power of attorney paperwork is a big thing that you can do right now
SPEAKER_02:yeah and maybe even if you have a parent that doesn't want to have that conversation like you were saying sometimes there's just a lot of resistance to that maybe having the conversation with those siblings instead. I think sometimes I see patients just as they're coming home from a major hospitalization where the kids are stepping in for the first time and they're finding that they're kind of surprised at how different their takes on the situation are. One is saying, of course, we're never going to move mom out of the house. And another is saying, there's no way that she's safe here, right in the middle of the most stressful Whereas maybe just having that conversation earlier, it's never a pleasant conversation, but just having that conversation earlier when it's not as stressful.
SPEAKER_00:Yeah. And I think there are some parents who are, who will be dismissive of the invitation from, from a child to talk about this. And, um, I think in that case, I would say recognize that's common. A lot of parents don't want to do this, and I would kind of frame that in their... desire to protect you. And maybe they're just a little bit scared too, because it's a hard thing to talk about, like you said.
SPEAKER_01:And
SPEAKER_00:if you really find like you're going nowhere with talking about this officially, then I would pivot a little bit to just making observations about how they're living and what's important to them. Have you ever thought about if you got sick enough to need a nursing home, what do you think about that? And often they'll say, well, I would never live in a nursing home. And I press them on that and say, really? Never? ever, ever? What if there are no alternatives? What if the alternative was hospice care at home? Is that what you mean by never? Try to figure out what they are willing to explore. And this may take time. This may take days, weeks, months, years to really hash this out. But I would still observe what their day-to-day is like and what they're showing is important through their actions and their lifestyle and at least start to build a profile of what Yeah, I think
SPEAKER_02:that kind of goes back to what you were talking about before also about being, you know, talking about what is the best option instead of what's the option that you want. I think it can kind of have the child feel a little bit more at ease. Also, when things aren't going well, you know, I'll see people who absolutely don't want to move out of there. And that's what they really want. And when they can say that clearly, then when they're having a hard time taking care of themselves, but they still are really adamant, everyone's just a little more at ease saying, well, this is still what they want. You know, another situation might be safer. You know, there's there's pros and cons to each, but neither one is going to be an ideal situation anymore. It's easier, I think, to say, OK, well, we know I know what you want. So even though it's hard to walk out of this house and know things aren't going to keep going wonderfully here, I still can feel a bit more at ease saying this is the decision that we're going with.
SPEAKER_00:Yeah. And I think what I would add to that is that for children who are asking their parents what they would want and they're not getting that engagement from their parents, the other common thing that I'll see in the hospital setting are families and children who say, man, I got I wish we had talked about this. I wish I had asked. And at least by asking, if something happens and you don't have a plan, at least you don't have to worry about what if. If you've asked and mom or dad shot you down, at least you could say that you tried and they weren't into it. And a common thing we say in palliative care is we have to meet people where they're at. And the reality is not everyone is going to want to talk about this, but there is value in extending the invitation to say, look, this is important to me that we talk about this. Do you think we could sit down and talk about it? And if they say no, at least you get a little bit of peace of mind saying you extended the invitation and you made an effort and you don't have to wonder what would have happened and what would have been different if you had asked when you didn't ask.
SPEAKER_02:Yeah. What's your advice for adult child who thinks their parent would be really appropriate for palliative care, but their parent is sort of resistant to that or maybe even resistant to health care in general.
SPEAKER_00:Oh, man, that's a whole that's a whole nother can of worms. I talk a lot about exploring resistance. So if if someone is shooting down an idea, try to try to figure out what they are willing to talk about. Right. To say, oh, wow, that was a really strong reaction. Help me understand where you're coming from here. And again, I always come back to what's the thought process here to kind of piece together values and priorities and sort of build a character portfolio of this parent. And just because someone says they do want palliative care, they don't want palliative care, they do or don't want health care in general,
SPEAKER_01:that
SPEAKER_00:doesn't universally translate to them not wanting to live as long as possible or them not wanting to be as healthy for as long as possible. There are often more dynamics at play here that you won't appreciate unless you ask. So I always start with exploring the resistance, which may sound something like, oh, tell me more where you're coming from here. Help me understand why you reacted that way. It's sort of a bigger communication tactic of naming dynamics. Every time something comes up in your household, like there's always a fight, naming the dynamic is taking a step back to say, I notice every time we bring up taking out the garbage, there's a big fight. Can you tell me Oh, I like that.
SPEAKER_02:All right. Anything else you're hoping to chat about? I
SPEAKER_00:think one of the biggest take-home points is palliative care is not, you don't need to give up anything to get palliative care. Palliative care is just more help for folks who are dealing with any serious illness that's impacting their quality of life, regardless of life expectancy or prognosis or anything like that. So there's no reason not to have palliative care involved when quality of life is at stake here. So jump on that website, getpalliativecare.org, and figure out what's going on in your area. And once you do hammer that out, I think the other thing I would add is that you'll likely need a referral from your doc, and you may have to use some of these bits of information and communication tactics to get that referral. If your doc still misunderstands what palliative care is, if you do find resistance from your doc about getting a referral for palliative care, again, I would take a step back and name the dynamic and be clear that you're looking for a All right. Sounds good. And then I
SPEAKER_02:mentioned your video that I watched about palliative care. Tell us a bit about your channel and the sort of things on there.
SPEAKER_00:Yeah. Thank you. So I relatively recently started a YouTube channel, which is called how to train your doctor. And this channel was born from my observation that when I meet with folks in the hospital and ask them, you know, what questions do you have about what's going on? Very, very often families and children of parents will tell me, I don't know what to ask right now. They're just, they're so overwhelmed and they don't, they don't have that X on the map. They don't even know where they are. Right. And so they don't, you don't, You don't know how to ask for directions if you don't know where you're trying to go. And this channel was meant to address that bit by bit with common communication deficits I see in doctors to give patients and caregivers and children of patients communication tips for having higher quality conversations with their doctors to help them better understand the healthcare system that they're navigating, especially when dealing with a serious illness, to hopefully just make them savvier advocates, either for themselves or someone else. taken care of. So check it out. Happy to give me your feedback of their other videos that would be helpful in this regard. Play it on me. I'm happy to make a video for whatever you're looking for.
SPEAKER_02:Yeah. All right. What a great resource. Okay. Well, wonderful chatting with you. And I have a feeling that we could talk for a lot longer about many other subjects. So maybe we'll have you back to talk about hospice or other decision making. Yeah.
SPEAKER_00:Happy to come back anytime. Thank you so much for having me. This was a great chat.
SPEAKER_02:Okay. Thanks. All right. Bye.
SPEAKER_00:Bye.
SPEAKER_02:Thanks again for joining me today and thanks to Matt for sharing his knowledge and wisdom. I hope you found it useful. You can find all the resources mentioned in this episode in the show notes. If you know anyone who you think would benefit from hearing our conversation and learning more about palliative care, please share this episode with them and visit Matt over on his YouTube channel, How to Train Your Doctor. You can connect with me at my website, ageoldquestions.com I'm always wishing you the best and I'll talk to you next time.