Dementia Talk #2: Props

How can we bring lightness and pleasure to our interactions with people with dementia? I like to use props, which can be any durable object suitable for show-and-tell.

Introducing a new object to a person living with dementia can spark their attention and stimulate curiosity. If the item means something special to you, that can help, too, since it will bring greater emotional depth to your encounter.

Here are three examples of items I like to bring with me when I visit someone with Alzheimer’s disease or another condition affecting memory or thinking.

The Octaband®

An Octaband® is a colorful fabric exercise tool to play with, indoors and out. The inexpensive, stretchy device comes in small (8-arm) and large (16-arm) sizes. When you play one-on-one with a partner, you position yourselves on opposite sides of the center circle and hold a colorful arm of the Octaband in each hand. The extra arms wave in the breeze — somewhat like flying a kite.

Octaband.com

The Octaband® is a colorful, stretchy, fabric exercise device developed by dance/movement therapist Donna Newman-Bluestein, DMT-BC, LMHC. It can be used in pairs or in a group. Photo from Octaband® LLC.

Octaband.com

Anyone can enjoy using an Octaband®. The silky fabric loops around the wrist, feels good in the hand, and encourages rhythmic stretching. Try it with music or sing as you play. Photo from Octaband® LLC.

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Hometown Photographs

When I get to know someone with dementia, I like to bring photos of the town where they grew up. Is it easier to recognize buildings than faces? I don’t know, but I’ve had some lovely chats with clients who remember going to the movies at the theater on Main Street or hearing summer concerts at the gazebo in the park. I download photos from the Internet to my smartphone or a tablet for easy sharing, but you could also have a copy shop print and laminate them.

Goodman Library, Napa, CA

The Goodman Library was my favorite building as a child in Napa, CA. It’s now the county historical society and on the National Register of Historic Places. Photo from NoeHill Travels in California.

Goodman Library in 1938, Napa, CA.

The Goodman Library in 1938. Napa County Historical Society photo from the Napa Valley Register.

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Lap Labyrinth

The labyrinth is an ancient design experiencing renewed popularity today as a platform for stress reduction. A lap labyrinth is a wonderful, portable alternative to the patio-sized or larger labyrinth for walking meditation. I coach my clients to hold the breathe as they move their fingers slowly along the grooves of the device, tracing the curves back and forth until the center is reached and then coming back out to the edge again. I support people in going at a faster pace if that seems more natural. It’s also fine to skip from one groove to another. Any path can bring this unusual object to life for a curious explorer.

A Pine Lap Labyrinth from Stress Resources.

Holistic nurse Pamela Katz Ressler, RN, MS, HN-BC, offers handcrafted pine labyrinths at Stress Resources. The lap labyrinth, also called a finger labyrinth, is a portable device used for stress reduction or meditation. Simply trace the grooves with your finger as you breathe gently. Notice the subtle sensations of touch, texture, pressure, movement, light, color, shadow, and even sound. Photo from Stress Resources, Concord, MA.

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What’s Your Experience with Props?

Do you use props as you interact with the person with dementia in your life? What works best: something familiar, or something new? How has this changed over time? Feel free to share your experience in the comments below. Or write me at mabartonst [at] gmail [dot] com. — MAB, August 9, 2015

PS: I offer examples of specific products based on my success in using them in my professional work with home-care clients. I am not not receiving any compensation for mentioning them.

Related: The first post in this series is Dementia Talk, already the top post in Joyous Paradox for 2015.

 

 

Dementia Talk

Editor’s note: What’s the most popular post on Joyous Paradox, my elder-care blog? How to Say Hello to Someone with Alzheimer’s Disease ranks way at the top. As a professional caregiver, I’ve had the privilege of working with many folks with dementia over the years. I learn more about the nuances of human communication with every encounter. In the coming months, I’ll be sharing tips for strengthening our bonds with those affected by memory disorders. Let’s begin the conversation with a superb overview of dementia communication strategies from England’s National Health Service. — MAB

Communicating with people with dementia

Grandmother and Grandchild by Lovis Corinth, German, 1919

Grandmother and Grandchild by Lovis Corinth, German, 1919, via Wikimedia Commons.

Dementia is a progressive illness that, over time, will affect a person’s ability to remember and understand basic everyday facts, such as names, dates and places.

Dementia will gradually affect the way a person communicates. Their ability to present rational ideas and to reason clearly will change.

If you are looking after a person with dementia, you may find that as the illness progresses you’ll have to start discussions to get the person to make conversation. This is common. Their ability to process information gets progressively weaker and their responses can become delayed.

Encouraging someone with dementia to communicate

Try to start conversations with the person you’re looking after, especially if you notice that they’re starting fewer conversations themselves. Ways to encourage communication include:

  • speaking clearly and slowly, using short sentences
  • making eye contact with the person when they’re talking, asking questions or having other conversations
  • giving them time to respond, because they may feel pressured if you try to speed up their answers
  • encouraging them to join in conversations with others, where possible
  • letting them speak for themselves during discussions about their welfare or health issues, as they may not speak up for themselves in other situations
  • trying not patronise them, or ridiculing what they say
  • acknowledging what they have said, even if they don’t answer your question, or what they say seems out of context – show that you’ve heard them and encourage them to say more about their answer
  • giving them simple choices – avoid creating complicated choices for them
  • using other ways to communicate – such as rephrasing questions because they can’t answer in the way they used to

The Alzheimer’s Society has several information sheets that can help, including ones on the progression of dementia and communicating.

Communicating through body language and physical contact

Communication isn’t just talking. Gestures, movement and facial expressions can all convey meaning or help you get a message across. Body language and physical contact become significant when speech is difficult for a person with dementia.

Communicating when someone has difficulty speaking or understanding can be made easier by:

  • being patient and remaining calm, which can help the person communicate more easily
  • keeping your tone of voice positive and friendly, where possible
  • talking to them at a respectful distance to avoid intimidating them – being at the same level or lower than they are – for example, if they are sitting – can also help
  • patting or holding the person’s hand while talking to them can reassure them and make you feel closer – watch their body language and listen to what they say to see whether they’re comfortable with you doing this

It’s important that you encourage the person to communicate what they want, however they can. Remember, we all find it frustrating when we can’t communicate effectively, or are misunderstood.

Listening to and understanding someone with dementia

Communication is a two-way process. As a carer of someone with dementia, you will probably have to learn to “listen” more carefully.

You may need to be more aware of non-verbal messages, such as facial expressions and body language. You may have to use more physical contact, such as reassuring pats on the arm, or smile as well as speaking. The following tips may improve communication between you and the person you’re caring for.

Active listening

When communicating with someone with dementia, “active listening” skills can help. These include:

  • using eye contact to look at the person, and encouraging them to look at you when either of you are talking
  • trying not to interrupt them, even if you think you know what they’re saying
  • stopping what you’re doing so you can give the person your full attention while they speak
  • minimising distractions that may get in the way of communication, such as the television or the radio playing too loudly, but always check if it’s OK to do so
  • repeating what you heard back to the person and asking if it’s accurate, or asking them to repeat what they said
  • “listening” in a different way – shaking your head, turning away or murmuring are alternative ways of saying no or expressing disapproval

This article contains public sector information licensed under the Open Government Licence v3.0

Parachute Riggers by Paraskeva Clark

Elinor Florence on the “Chute Girls” of World War II

Author Elinor Florence

Canadian author Elinor Florence shares wartime stories.

Editor’s note: Canadian author Elinor Florence shares stories and pictures of life in World War II in her blog Wartime Wednesdays. Here is her fascinating photo story of Canada’s female parachute packers, reblogged by permission. I wonder how changing attitudes toward women’s roles in the 70 years since the war have affected the way we remember those who served. Have you talked about working women in wartime with your family? — MAB 

Featured image (top): Parachute Riggers by Paraskeva Clark, Russian-born Canadian, 1947, via Canadian War Museum. 

Cheers to the Chute Girls!

Of all the work performed by women in uniform, packing parachutes — those complicated contraptions of silk and leather — meant the difference between life and death for a man plunging from the sky.
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Canadian airwomen check the folds in a parachute during World War II. Photo credit: Canadian War Museum.

Here’s a photo of some very smart-looking Canadian women carefully laying out a parachute on a long table, checking that every fold is in place.

There was a tremendous need for parachutes in World War II.

Fliers not only needed them during training (especially then) but every time they went out on operational flights. During the six-year conflict, hundreds of thousands of parachutes were sewn, packed and distributed. Twenty thousand parachutes were opened in a single mission, dropping paratroopers into France on D-Day.

And for the most part, parachute packing was women’s work.

In the book We Serve That Men May Fly, the story of the Royal Canadian Air Force Women’s Division, author Mary Ziegler quotes one officer, explaining why women were particularly suited to the job.

“Take parachute packing. To a man it’s a dull, routine job. He doesn’t want to pack parachutes. He wants to be up there with one strapped to his back. But to a woman it’s an exciting job. She can imagine that someday a flier’s life will be saved because she packed that parachute well. Maybe it will be her own husband’s life or her boyfriend’s. That makes parachute packing pretty exciting for her, and she does a much more efficient and speedy job than an unhappy airman would.”

Perhaps there was even some truth to this outdated attitude!

Foothill Fliers was the station newsletter of No. 3 Service Flight Training School in Calgary, and in the October 1943 issue, it published an article titled: “Temptations of a ‘Chute Girl.”

Foothill Fliers was the station newsletter of No. 3 Service Flight Training School in Calgary, Alberta, during World War II.

“Temptations of a ‘Chute Girl” by Corporal Muriel Ellis. No. 3 Service Flight Training School, Calgary, Alberta, 1943.

Although the article was written by a woman, Corporal Muriel Ellis, she kept the tone light. Here’s an excerpt:

“Ever miss those nice sheer pre-war silk stockings, girls? When you work all day with enough silk to make stockings aplenty for the next eight years, wearing cotton stockings, it’s a great temptation to whip out the scissors. Particularly now, when real $1.50 chiffons are as scarce as beefsteak in Berlin.

“That’s what the girls in the parachute section, packing six to eight chutes a day, and thinking of the dear, dead days of silk-legged delight, are up against. The silk from one chute would make no less than 160 pairs of stockings, and if you like Nylons, there’s 200 pairs of them in one of the big umbrellas.

“Chute rigging has been on of the chief activities of the Women’s Division since Ottawa decided that there were hundreds of jobs in the air force that could be done by the ladies. And, as you can see, one of the most ironical jobs.”

The photo below shows AW1 A.S. Olive packing a parachute at Wolseley, Saskatchewan. Behind her you can see the individual cubbyholes, where each parachute was kept until checked out before a flight.

AW1 A.S. Olive packs a parachute at Wolseley, Saskatchewan.

In spite of this humorous approach, packing a parachute was far from simple. Here’s one description of how it was done:

“The main canopy is 56 square yards of silk and is 24 feet in diameter. Fastened to the pack are two rings known as the D rings. From the right ring run 12 rigging lines up the right side of the canopy and down the left side and then fasten on the left ring. These lines measure 52 feet apiece and total 700 feet. The canopy and lines are stowed in a small pack 11 inches by 16 inches in concertina fashion. The placing of such a large quantity of silk and lines in such a small space is a very intricate operation and well worth witnessing. The weight of the parachute complete with harness is 25 pounds.”

Sounds pretty complicated, doesn’t it?

Before the parachute was packed, it had to be minutely examined for flaws. Here’s a group of civilian women inspecting a parachute.

 

Civilian women inspect a parachute. Photo Credit: Bettmann and Corbis.

It was also examined in a hanging position. According to the article in Foothills Fliers:

“Each fold must be exact, all rigging or shroud lines must be in the pockets straight and true. The metal fittings have to be kept free from rust, and a dozen other things checked to insure the fast opening of a parachute. For a chute must not only open, it must open fast!”

Each parachute is also examined in a hanging position.

Then came the tricky business of folding it correctly, so the delicate lines wouldn’t get tangled and caught up when the silk unfurled. Once again, the racks containing the packed parachutes are visible in the background.

Then comes the tricky business of folding the parachute correctly.

The below photograph of Beatrice Jennox was copied from the book We Serve That Men May Fly, the story of the RCAF Women’s Division, by Mary Ziegler.

Women of all nationalities and branches of the armed forces performed this vital task. Here an American WAVE (short for Women Accepted for Volunteer Emergency Service) demonstrates parachute packing techniques. Later this branch became known as the U.S. Naval Reserve (Women’s Reserve), but the nickname WAVE stuck.

The lettering on the parachute bag indicates that the location is Naval Air Station, New York. Note her Parachute Rigger rating badge, and framed prints of Navy life on the wall behind her.

 

An American WAVE (short for Women Accepted for Volunteer Emergency Service) demonstrates parachute packing techniques. Photo credit: U.S. Navy, now in the collection of the National Archives.

The care of the parachute was also of great importance. Records were kept to ensure parachutes were tested regularly.

The chute was opened and hung up for 48 hours to enable it to air; weather permitting, the parachute was taken outside and aired by nature, ballooning with the wind. It was then well shaken to get rid of any insects.

At periodic intervals, the women also went up in an aircraft and “drop-tested” the chutes, attached to 180-pound dummies. According to the Foothill Fliers: “The girls feel like bombardiers as they circle the drome at 100 miles per hour, hefting the dummies out!”

Here’s a group of WRENS (Women’s Royal Canadian Naval Service) checking to see that a parachute is filling correctly, by opening it in the wind.

A group of WRENS (Women’s Royal Canadian Naval Service) checks to see that a parachute is filling correctly.

If a tiny hole or weak spot was noted, the parachutes had to be carefully mended. This painting by Paraskeva Clark, who was appointed by the National Gallery of Canada to record the activities of the women’s branches of the armed forces during wartime, shows the process of sewing the parachutes.

Parachute Riggers, 1947, by artist Paraskeva Clark. She was appointed by the National Gallery of Canada to record the activities of the women’s branches of the armed forces during wartime. Image credit: Canadian War Museum.

The intense expression on three of the women’s faces draws attention to their tasks of cutting, folding, and securing the lines of the parachutes. This 1947 oil painting is part of the Beaverbrook Collection of War Art at the Canadian War Museum.

Here’s a photo of women mending chutes at No. 38 Wing RAF & Airborne Division Headquarters. You can see by the volume of fabric and the number of lines that this was a fairly cumbersome job.

Women mend chutes at No. 38 Wing RAF & Airborne Division Headquarters.

Mary Purdue, whoever she was, was named in this advertisement for an American brand of cereal as a Champion Parachute Maker.

Editor’s note: A 1940s U.S. cereal ad paid tribute to a Champion Parachute Maker. To see the whole ad, visit http://bit.ly/1Mj2Ee3.

The parachute-packing women were intensely aware that their activities were of the utmost importance.

A sign on the wall behind these members of the Women’s Auxiliary Air Force reads: “REMEMBER, A MAN’S LIFE DEPENDS ON EVERY PARACHUTE YOU PACK!” I doubt very much if the sign was necessary.

Parachute records noted when it was packed, and by whom, so every parachute could be traced back to its packer.

A sign on the wall behind these members of the Women’s Auxiliary Air Force reads: “REMEMBER, A MAN’S LIFE DEPENDS ON EVERY PARACHUTE YOU PACK!”

Many men died no matter how well their parachutes were packed. And in each fatality investigation, the parachute had to be inspected to see whether it was a factor.

Anna Dundas (née Mayer) of Winnipeg enlisted in the RCAF Women’s Division in January 1942 and served at No. 10 Service Flight Training School in Dauphin, Manitoba. You can read her whole story by clicking here: The Memory Project.

Anna Dundas of Winnipeg remembers inspecting the parachutes of airmen who had crashed.

Here she describes one sad but memorable incident :

“There were three of us in that section. We had to inspect parachutes for rips or tears and hang them in a well to air them for 48 hours, and then repack them.

“The only time I was nervous inspecting a parachute was where they brought it in after a crash and it had burned. And we had to go through it. We, when I say we, I had to. I was the only one that worked on it, to make sure there were no body parts in it. And the smell of that burnt silk was very, very strong, it was nauseating. And it was kind of a daunting job. But we had to do it, that was part of the ritual, before they could throw it out.”

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Another woman named G.D. Martineau wrote an eloquent poem about her feelings, describing her anxiety at the importance of her work.

The Parachute Packer’s Prayer

 G.D. Martineau

When they posted me here to the section,

I was free as the pitiless air,

Unashamed of confessed imperfection,

Having no sort of burden to bear.

I was not an incurable slacker;

Neat, not fussy – I fancied of old,

But today I’m a Parachute Packer,

And my heart takes a turn with each fold.

When I think how I snugly resided

In the lap of this land we could lose,

I believe if I left one cord twisted,

I would place my own neck in a noose.

So I lay the fine silk on the table

And I lift each pale panel in turn.

They have said that my folding is able

But it took me a long time to learn.

For the cords must come free for smooth flowing

And the webbing attachment be stout,

For the brute of a breeze will be blowing

If the aircrew have to bale out.

‘Cos the flyer must float unencumbered,

Come to earth to complete the design,

See, the ‘chute has been carefully numbered,

And the name in the log book is mine.

So is conscience awakened and care born

In the heart of a negligent maid.

Fickle Aeolus, fight for the airborne,

Whom I strive with frail fingers to aid.

Give my heroes kind wind and fair weather,

Let no parachute sidle or slump,

For today we go warring together

And my soul will be there at the jump.

I found the last two lines very moving: “Today we go warring together, and my heart will be there at the jump.”

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Here is the best story of all, and one that I located after much diligent searching of the Internet. It comes from a small town newspaper in Watkins Glen, New York called The Watkins Express, dated July 7, 1943.

This man, RCAF Flying Officer J.R. Delaney, had managed to bail out of his burning plane and was saved. In gratitude, he sought out the parachute packer, a young woman named L.A.C. Irene Camken, who worked in a parachute packing station in Rockcliffe, near Ottawa. Flying Officer Delaney was from Mount Vernon, New York.

A grateful airman visits Leading Airwoman Irene Camken at her RCAF station to thank her for packing the parachute that saved him. Credit: The Watkins Glen (NY) Express, July 7, 1943.

And because the old clipping is a little blurry, here is a transcript:

BRINGS HIM BACK ALIVE

When a flier has to bail out of his aircraft, he not only appreciates the parachute that does the trick of saving him, but looks on its packer as the person who threw a life preserver when he started to sink.

Flying Office T.R. Delaney of Mount Vernon, New York, who recently jumped from a flaming aircraft, landed safely and went to the parachute section of the Royal Canadian Air Force Station at Rockcliffe to thank the airwoman who “brought him back alive.”

She is Leading Airwoman Irene Camken, daughter of Mr. and Mrs. Frank Camken of Belleville. Formerly a fabric worker at the Cooey Metal Works, Brighton, Ont., LAW Camken enlisted in the Women’s Division of the Royal Canadian Air Force fourteen months ago, and has been packing parachutes ever since. In her estimation, that is a real war job.

“You can never let yourself forget how important your work is when you’re packing ‘chutes,” she said. “It isn’t your life that depends on them. It’s somebody else’s, and your best is the only job that’s good enough.”

Now transferred to another station of the RCAF, LAW Camken took along evidence of how good her “best job” can be. It is a new identification bracelet, one shining side bearing the RCAF crest, her name and Women’s Division number. The other is the side she prefers. That reads: “With sincere thanks, T.R. Delaney.”

On behalf of all those men who fell safely from the sky — not to mention their mothers, sisters, and wives — I want to send a big Cheers to the Chute Girls, wherever they are now. Happy Landings!

Bird's Eye View by Elinor FlorenceAuthor Elinor Florence grew up on a Saskatchewan grain farm that was the site of a wartime training airfield.  Her historical novel, Bird’s Eye View, tells the story of a female Canadian intelligence officer who works as an aerial photographic interpreter in World War II Britain.

 

The Misses Santley by Henry Scott Tuke

Singing with You Is Our Prayer

“Singing,
singing with you,
singing with you is our prayer.”*

In the lamplight
on a Thursday evening,
we halt the ticking of the old clock
on the parlor wall,

breathe deep,

open the heart,

remember those we love —
remember those who need love —
remember how it was, so long ago,
that our ancestor-women
and our men, so long departed,
sang at the bedside.

Deep voices and treble,
we practice those chants and songs
most beloved for healing
or distraction
or reminiscing
or conjuring tranquility.

We come to your bedside
or your kitchen table.

Singing with you
is our prayer.

— Mary Ann Barton

* Lyrics by the Reverend Burns Stanfield

Cities Are Not Empty Pages

“Cities are not empty pages,” writes German sociologist Rolf Lindner. He continues, “There are cities which are like a penny dreadful, a dime novel, stained and well-thumbed and with a garish, torn cover, while others are more like an expensive edition of a classic author, leather bound, with thread-stitching and a bookmark. “– Rolf Lindner, “The Cultural Texture of the City,” Linköping University Electronic Press, 2006.

Growing Old in East Harlem: a video about the East Harlem Aging Improvement District from The New York Academy of Medicine on Vimeo.

Dear Readers,

For me, urban life is more memory than presence. Since 1977, I’ve migrated from big-city Chicago to small-town Henniker, NH, to suburban Boston. I visit cities mostly for refreshment, these days, instead of daily needs.

Yet a film set in East Harlem, New York City, has brought me back to the jam-packed, extravagant, messy, compelling pages of the urban life I knew as a teenager and young adult in Chicago. Watch “Growing Old in East Harlem.” You’ll see the pages fill up with stories.

Thanks for being here,

Mary Ann

PS: Below is a description of the film from the New York Academy of Medicine. You can read more about East Harlem’s status as an Age-Friendly City at the Silberman School of Social Work.

“On August 31, 2010, NYAM previewed a new film, “Growing Old in East Harlem” in which seniors were interviewed about the joys and challenges of aging in this diverse, dynamic neighborhood in New York. Growing Old in East Harlem was filmed and directed by Dorian Block, policy associate at NYAM. It was produced and edited by Jonathan Mena and Jessie Daniels, both of Hunter College.

“More than 200 older adults, community leaders, and business representatives from East Harlem gathered at NYAM to view the film and to discuss the findings of a recent study of older adults in East Harlem who expressed concerns and improvements they would like to see in their community. The assessment and resulting event are part of Age-Friendly NYC, a collaboration between NYAM, the Mayor’s Office, and the New York City Council.” — NYAM, 2010

Jesse and the Typewriter Shop

Editor’s note: I took typing one summer at Schurz High School in Chicago and still remember the class fondly. Mary Maldonado and I used to walk home from class together in the suffocating heat of a Midwestern city. Sometimes I’d walk her all the way to her house, hoping to catch a glimpse of her older brother, Paul, who played bassoon in my high school band. I still have my mother’s pale green Olivetti typewriter that she lugged around in her post-retirement travels from Chicago to Kentucky to Montana to New Jersey to New Hampshire to Massachusetts.  Here, reblogged from The Casual Optimist, is a touching film about father-and-son typewriter repairmen in Los Angeles. Do you have an old typewriter somewhere in the house? Do you still use it? — MAB

Related to yesterday’s post on Gramercy Typewriter Co. in New York, here’s a short film about U.S. Office Machines, one of the last remaining typewriter repair shops in Los Angeles:

(Thanks Sam!)

Dr. Atul Gawande in Being Mortal, a Frontline documentary on PBS

“Being Mortal” Airs Tonight

“The two big unfixables are aging and dying…you can’t fix those.” — Atul Gawande

Editor’s note: PBS airs a documentary tonight based on Atul Gawande’s book Being Mortal. It promises to be a candid and intimate look at doctors and families coming to terms with the end of life. This article by Stephanie E. Rogers, MD, appears in the blog Geripal. — MAB, 2/10/2015

The True Art of Medicine: Atul Gawande and The Being Mortal Documentary

by Stephanie E. Rogers, MD @SERogersMD

“The two big unfixables are aging and dying…you can’t fix those,” notes physician-writer Dr. Atul Gawande, in a new documentary based on his recent book Being Mortal. The Frontline documentary airs Tuesday, February 10 on PBS, and explores Gawande’s frustration of not being able to “fix” all of his patients.

The Being Mortal documentary examines how Gawande and other physicians struggle to talk with patients and families about death and dying. He explores his own humble journey with the realization that “medicine fails the people it’s supposed to help” at the end of life. It also provides a powerful, intimate look at families struggling with conversations about the realities of aging and death, and the uncomfortable and difficult time even well-trained physicians have at leading these discussions.

One of the most startling aspects of the documentary is watching physicians participate in these conversations with patients and the behind the scenes look at what their thoughts are regarding these discussions. Even with cancer physicians who have these conversations all the time, it is apparent that they too are struggling to be forthright and eloquent. In fact, this is what makes Gawande a skillful storyteller — he exposes his own vulnerabilities both as a physician trying not to be the bearer of bad news and as a patient’s family member during his father’s inevitable death from a spinal cord tumor.

“Hope is not a plan,” Dr. Gawande argues. “We find from our trials that we are literally inflicting therapies on people that shorten their lives and increase their suffering, due to an inability to come to good decisions.” He notes that people may have other priorities besides living longer and that we should not be waiting until the last week of life to have these discussions with our patients.

As a Geriatrics fellow, I have learned that speaking to patients frankly about aging, dying, and their priorities for the time they have left has been the toughest challenge I’ve encountered yet in my decade of medical training. We physicians tend to be overly optimistic and timid about the truth, partly because it is difficult to tell a patient something they don’t want to hear. We want to instill confidence in our patients and hope with them for a cure or more time.

I now realize that the most worthy challenge– one likely to last my entire career – is to improve my ability to have these conversations. Our decisive goal as physicians is not only to know the most up-to-date scientific studies or treatments, but to be comfortable and capable of communicating truthfully and empathetically to our patients about the realities of life — that we will all age and we will all die. The true challenge is combining all our medical knowledge and skills with the art of communication, to allow our patients to choose how they want to live—all the way to the end. Being Mortal, the Frontline documentary from writer/producer/director Tom Jennings, airs Tuesday, February 10 on PBS and will stream in full online at pbs.org/frontlinehttp://pbs.org/frontline.

Source: Stephanie E. Rogers, MD, “The True Art of Medicine: Atul Gawande and The Being Mortal Documentary,” GeriPal: A  Geriatrics and Palliative Care Blog (blog), February 9, 2015, http://www.geripal.org/2015/02/atul-gawande-being-mortal-documentary.html.