Engage with Grace

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This is a Presentation about end of life, palliative care and hospice.

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  • Dearest Alex,
    You too are on my short list. My Aunt Minnie is currently in Hospice and probably leaving this world today. My sister is at her side. It is such an honor to be there at the end.
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  • Have been through it four times. Each time I find something new. Each time I recommit to this mission...to ferociously and passionately and deliberately reimagining what we as a country, as a system, as individuals with mums and dads and partners and children and friends and lovers experience at end of life...that it be intentional, that it be surrounded by and uplifted with love, that it have grace. Regina Holliday - you are on my forever short list for the intensity and purpose ...and grace....you bring to all you do. Thank you for being on this mission, and I got your back, sister.
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  • Thank you Lisa...
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  • Regina Holliday focuses on the patient journey from primary care office, to triage, through hospitalizations and even into her hospice experience during this speech. Throughout her presentation, she interjects elements of daily life, loves, laughs and tears into a clinical space. Objectives: • Discuss importance of patient and caregiver access to data for informed choice • Describe societal perceptions of palliative and hospice care • Identify solutions to improve access to palliative care and hospice care in a timely fashion
  • Engage with Grace

    1. 1. Engage with Grace A presentation by Regina HollidayBe Ahead of All Parting a jacket painting for Bart Windrum Thoughts on hospice, palliative care and informed choice.
    2. 2. It is a common sight.Look in the alley in a business district.A pile of pallets is stacked beside the trash. Are they refuse? Are they at an end?When I first saw the wordPalliative CareI thought of these.
    3. 3. HOSPICE The first time I heard this word was in whispered conversation as my Aunt Bertha was dying painfully from cancer. I visited her at her home before she died at the age of 83. She had chosen aggressive treatment. I looked at her paper-thin skin and her drawn face. I hugged her. She held me close and said:“I would have never chosen this if I knew how much it would hurt. I don’t want to hurt anymore.”She died one month later.
    4. 4. I know my Aunt Bertha was 83 when she diedbecause my Aunt Hilda gave me this book.It is a Birthday Book. It rejoices in life.My Aunt Hilda filled out the dates for ourentire family prior to giving it to me.Life has a beginning and an end.Both should be remembered and respected.Aunt Hilda died in Hospice care at the age of 89.
    5. 5. Sometimes our friends and familylive a long full life before it ends.Sometimes they die young.I am Regina.I am named after a great Aunt Reginawho died at the age of five from scarlet fever. My mother embroidered this prayer that hung above my bed as a child. Every night I prayed and was reminded that this night could be the last. That death was part of life.
    6. 6. Do you know about Engage with Grace?Alex Drane created this slide after losing a family member.
    7. 7. Every Thanksgiving we are supposed to engage in grace and ask these questions. So we know in advance our loved ones wishes. But my husband Fred and I did not know this. We had to have this discussion in a hospital room. Alone.
    8. 8. The Holliday Family Christmas 2007
    9. 9. Everything we ever wanted… Resolutions January 2008:1. Get Medical Insurance for the whole family 2. Get little Freddie into a special needs school 3. Fred gets a job in his field 4. Spend more time together as a family 5. Get a two bedroom apartment Freddie’s IEP Binder
    10. 10. Fred was happy with his new job.But he was very tired,He went to the doctor and wasdiagnosed with hypertension.
    11. 11. During the months ofJanuary, FebruaryandMarch of 2009,Fred was in constant pain.
    12. 12. On Friday March 13th, We went to the ER because Fred was in so much pain .We waited three hours before being sent home.
    13. 13. Fred was hospitalized on March 25th 2009 for the administration of tests.On March 27th, he was told while alone thathe had “tumors and growths.”He was scared and confused and did not understand.His oncologist left town for the next four days to a medicalconference and was not reachable by phone or email.
    14. 14. What was the diagnosis? What were the treatment options? Would he get a pain consult?
    15. 15. We were told we needed to fill out a medical power of attorney and an advance directive, but aswe were District residents and Fred was hospitalized in Maryland they did not have the forms. I would have go home and print them out.
    16. 16. This is my husband’s medical record.I was told it would cost73 Cents per pageAnd we would have to wait 21 days to get acopy.
    17. 17. “Go After Them, Regina.” April 18, 2009
    18. 18. After waiting for 5 days for a transferto another hospital for a second opinion,We were sent with an out of dateand incomplete medical recordand transfer summary.The new staff spent 6 hours trying tocobble together a current medical recordUsing a telephone and a fax machine.
    19. 19. This is thevital clinical informationfrom Fred’s electronic medical record.Presented in the style ofthe Nutrition Facts Label.Then painted on the wall ofPumpernickel’s Deli inWashington, DC.
    20. 20. Why did we get more help and answers from Social Media than from our local hospital ? Within one day were in email contact and then spoke on the phone. By ten o’clock May 4th 2009, I was talking on the phone with Dave’s Oncologist about my husband’s cancer.I am trying to talk with Christine Kraft and epatient Dave.
    21. 21. Going to Hospice.
    22. 22. We fulfilled our final 2008 resolution on June 11th 2009.We moved into a two bedroom apartment so I could care for Fred in home hospice. He died six days later on June 17th, 2009
    23. 23. This is the painting 73 cents.This is the vital patient story, the social history , the sacred heart of Fred’s ELECTRONIC MEDICAL RECORD.This is the painting of a journey from hospital, to hospital, to rehab, tohospital, to rehab, to hospice and finally home hospice.Every transfer needed an advance directive and finally a DNR.
    24. 24. So, are you prepared for this?Some of us will die well; held in loving arms as we end. All of My Children." a jacket for Mindy Schwartz-Brown
    25. 25. "The Truth Upon These Shores" a jacket for Morgan Stanley-Kominers from those that Love us. Some of will die far away
    26. 26. In either case, we need an electronic record that can follow us and includes our final wishes.“Paper Chaos” a jacket for Michelle F. Davis
    27. 27. It is hard enough to die; It is hard enough to lose the ones we love. We should have a system that allows us to Engage we Grace and"Grief" a jacket for Ann Becker-Schutte have a death with dignity.
    28. 28. “Sacred Media” for Lisa Fields Thank You @ReginaHolliday

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