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Conversation Group Medical Visits

Conversation Group Medical Visits:
An Empowering Group For Older Patients

The majority of older adults seem to avoid discussion of their end-of-life wishes. But their feelings on the subject usually lurk just below the surface, without any thought or plan being made. In their minds, to discuss their thoughts would mean they are very ill or that talking about it makes it too real. They don’t think they are “old enough,” forgetting about all of the younger lives that have already ended.
There’s a valuable new program being run at University of Colorado Hospital Primary Care and Seniors Clinics which greatly benefits older patients. Dr. Hillary Lum, UCH Geriatrician, has received a grant from the Colorado Health Foundation and the University of Colorado Primary Care Strategic Initiative Fund to hold informative discussion groups that gently open this topic within a small group of patient peers. The group is facilitated by Dr. Lum and Pat Schulof, a Licensed Clinical Social Worker. It’s a program called “The Conversation Group Medical Visit,” held in two 2-hour sessions, about a month apart. Patients must be 65 or older. This group is currently being offered to patients of Seniors Clinic and University Internal Medicine - Anschutz.
Within the privacy of the group, participants receive information about designating a family member or loved one to carry out their end-of-life wishes. They discuss what medical measures they are willing to accept at that time. Do they want to die at home or in a care facility? If their physician says they can implement breathing machines, resuscitation, feeding tubes…what would that patient decide if he/she were able? As one patient remarked, “Making these choices now, while I am well, is like giving a gift to my son, so he will know what I want and only fill my expressed directions. It’s a load off my mind and probably his as well.”
By the second Conversation Group Medical Visit, participants have had a chance to think about what they learned and ask specific questions. They are made aware of legal documents they may execute if they wish. They are encouraged to have a personal discussion with their doctor on this topic to further explore their options and make it part of their medical records. In previous Conversation Group Medical Visits at UCH, participants expressed gratitude and relief about knowing their options and planning ahead.
If you would like further information about this quality improvement program, please contact Sue Felton, Program Coordinator, at 303-724-2253.
This article was initiated and written by a patient who participated in the Conversation Group Medical Visits in Jan-Feb 2014 and is now a patient research partner.