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Wellness Center

AIM: The Conversation Project

Get ready to talk about end of life at every age

When Todd Shields turned 40 this year he wrote down a list of 40 things he wanted to accomplish before he turns 41. One of them, he said, had to do with creating a will and talking about his end-of-life wishes with his wife.

AIM: The Conversation Project

"It's hard. Having those conversations is hard," Mavity said. "It's talking about things you hope won't happen, but are going to happen at some point. Having these conversations means embracing our mortality."

"My best friend growing up passed away last year at 38, suddenly. I think about it all the time," said Shields, the Centers of Care director for St. Charles Health System. "I don't want my family to be burdened. I don't want them to have to second guess or have doubt."

To get started on the process, Shields met with Katie Hartley and Dr. Laura Mavity, directors of the St. Charles Advanced Illness Management Center of Care, to learn about The Conversation Project. St. Charles is one of 12 health systems in the country selected to participate in the Institute for Healthcare Improvement's Conversation Project as a pioneer sponsor.

"The transformative goal is to have every person's end-of-life wishes expressed and documented," Hartley said. "We know that 82 percent of people say it's important to put their wishes in writing, but only 20 percent of people actually do. Seventy percent of people say they would like to die at home, but in reality 70 percent of people die in a hospital, nursing home or other care facility."

The Conversation Project website provides a tool kit to help people of all ages think about what matters most to them, what brings them joy and what they would consider to be an acceptable quality of life. It also walks people through the legal steps of documenting end-of-life wishes including completing an advanced directive and a POLST — physician orders for life-sustaining treatment — form.

Because St. Charles is a pioneer health system for The Conversation Project, Hartley and Mavity are launching several pilot projects in an effort to introduce the toolkit to the Central Oregon community. Mavity attends St. Charles' new Heart Failure University to present The Conversation Project and Hartley follows up with a phone call to participants to see if they have visited the website and started on their own conversations with their loved ones.

"It's hard. Having those conversations is hard," Mavity said. "It's talking about things you hope won't happen, but are going to happen at some point. Having these conversations means embracing our mortality."

As a palliative care specialist, Mavity regularly sees first-hand how difficult it can be for families to make decisions about care if they don't know what their loved one would have wanted and the loved one can no longer speak for him or herself. "When people haven't had these conversations, the risk is they can receive health care that they wouldn't want — whether that is overly aggressive or under aggressive," Mavity said. "If we have some sense of what they would have wanted, that is always the right decision."

For more information on The Conversation Project visit www.theconversationproject.org.