My Health, My Decisions: A Discussion on Advance Directives with Mike O’Connell & Dr. Kirsten Severson – Transcribed

[00:00:00] Pete Waggoner: Hello again, everybody. And welcome to good grief. The podcast from the O’Connell family funeral homes. Be sure to check us out at Today on the phone, it’s gonna be Michael O’Connell as he joins us with Dr. Kristen Severson. And we’re gonna be talking today about this is a good discussion in medicine specifically about advanced care directives.

[00:00:27] We’ll talk about what you talk with your healthcare provider about why and what makes good sense for all of us. So thanks again for joining good grief and Michael O’Connell, you know, you yourself are not with us in the studio right now, as you had a bit of a scare. So you at this stage of healthcare, that is you at this stage are very comfortable with this topic because it’s very recent for you.

[00:00:50] So first of all cheers to you and we hope you’re feeling well. 

[00:00:54] Mike O’Connell: Thank you, Pete. Hello doctor. Yes. I had a little scare. I had kidney cancer was found accidentally [00:01:00] and I had surgery a week ago. They removed it part of my kidney and I am cancer free. So amen to that. So all these questions we’re talking about, I was forced fed them a week ago today. 

[00:01:12] Pete Waggoner: Wow. So one week ago, it’s amazing doctor how the one week ago today’s and the things think about if this was 30 years ago, we would know. I mean, it wasn’t automatic. Right? Exactly. So the advancements are absolutely stunning. Aren’t we lucky? 

[00:01:28] So let’s talk about advanced directives and let’s start first with you, dr. Severson, what is an advanced directive? And personally, I come to this, I’ve never heard of it. So I’m excited to learn more. So what is it? 

[00:01:39] Dr. Kirsten Severson: Well, it’s a broad umbrella term for a couple of different legal documents that allow us as stubborn, stoic individuals to guide our end of life care.

[00:01:50] Like we do everything else. Like finances, like home things like our vacation plans. We have the right and actually obligation to tell our healthcare providers what’s important to [00:02:00] us as we look forward thinking about how we want to die. 

[00:02:04] Pete Waggoner: So, how is this different from offs script a little bit here from perhaps a will or does it play into that?

[00:02:12] Dr. Kirsten Severson: Totally different. The traditional will that we worry about is, who gets my jewelry, who gets the convertible, where does a house go? And this has nothing to do with it.

[00:02:21] What we’re talking about today is purely related to healthcare decisions, not money, not properties. And so under this umbrella term of advanced directives are two different kinds of things. One is a living will that I think of as a frosting on the cake documents. And then the other one that I think is super, super important in the practical piece is the power of attorney for healthcare. And the power of attorney for healthcare is a very simple document to fill out.

[00:02:50] It really is a check box for about four questions. And then it allows me to choose who I know and trust to be my voice [00:03:00] when I can’t be my own advocate. 

[00:03:03] Pete Waggoner: Gotcha. So this is not to be confused. It’s completely different from those other things. And I wonder from a percentage point perspective, how many people just trolling around out here?

[00:03:14] Would you, I mean, I bet you, a lot of people don’t even think they should do something like this. 

[00:03:18] Dr. Kirsten Severson: Exactly. In my practice, it’s adults. So it’s generally 18 till 118. And the great majority of them are grown up grandparents. I’d say 50, 50. They look at me like, what the heck are you talking about? I’m like, hello, you’ve been in healthcare. You’ve been sick. Hello. Where are you? Some people work in healthcare and they have no clue. I’ll deal with it later. And we don’t have later. Yeah. 

[00:03:42] Pete Waggoner: Right. Because later doesn’t tell you when either. So why would you do it? I mean what are the best benefits of it? 

[00:03:47] Dr. Kirsten Severson: Cause I’m a control freak, and I don’t want somebody else making decisions for me.

[00:03:52] Pete Waggoner: Including family?

[00:03:53] Dr. Kirsten Severson: Oh, absolutely. Nobody. It my body, it’s my life. And I want to [00:04:00] direct what happens when things look not so very good either for the better or not. And I know that a lot of times doctors can look at a medical chart and say, this person is looking at limited life expectancy.

[00:04:12] You should stop. And don’t and don’t, but the person might have good reasons for saying, do everything and go everywhere. That’s their decision and their right. But on the flip side, a lot of doctors also are afraid to give up and say we can’t fix. And so we put people through what I call the medical model that people may not want.

[00:04:34] And they may say, you know what, let’s back away from that because that’s not important to me. I don’t wanna be in the hospital and the medical model and they have a right to say that, and then we can help them on that journey. 

[00:04:46] Pete Waggoner: And then it also from our notes here, I’m saying it can limit family conflict when these types of discussions come up.

[00:04:52] I mean, if you can solve a lot of problems by taking control, like you said earlier. 

[00:04:57] Dr. Kirsten Severson: Yes. Be proactive. 

[00:04:59] Mike O’Connell: So I’ve got a [00:05:00] question then doctor, so in the funeral business, and that’s how I can relate is if somebody says well, and it even write it down on a cocktail napkin that, you know, I want this, I want it at this church, or I want, I don’t want it at that church, blah, blah, blah.

[00:05:15] And they don’t do anything. Or for example, that I am, I’ve got that sticker on my license that says I’m an organ donor, which you and I both know, that’s not organ donation. That’s for the, for the organs when you’re living, but the family can override it. So I know in the funeral business that we have a Rite of disposition that if signed, I could have.

[00:05:36] My writeup disposition, which overrides my next step kid, my wife. So when you sign these and these advanced directives, you can put Pete as your advanced directive lead over your next of kin and they can’t ride that, is that correct? 

[00:05:52] Dr. Kirsten Severson: Very, very much so. And that’s a great point. Each state is different in what their laws are, and if we [00:06:00] look at our neighboring Minnesota, Illinois, If I don’t have a power of attorney for healthcare document, there is an automatic default pecking order that the law has established a spouse, an eldest child, et cetera, to be my voice when I can’t. Wisconsin does not have that.

[00:06:18] And a lot of people are completely unaware of it. So if I don’t name somebody, then my family and friends have to petition the court for guardianship. And when I’m acutely ill and there’s a lot of emotion and a lot of health changes, the last thing I’d want is to put my family through a legal system. In order to be my voice.

[00:06:38] And so then to piggyback on your question, just because I have family, it does not mean that that person is the best voice and decision maker for me, because oftentimes family is too emotionally close and it’s hard to separate what they want compared to what my wishes are. This document does not allow them to be [00:07:00] carrying out their wishes for me, they have to be my voice for what I have told them is important. And so some people say, I don’t want my spouse or my kids. I want my neighbor, my childhood friend, because they are detached enough that they can be my voice.

[00:07:18] Pete Waggoner: Kind of less emotional. 

[00:07:19] Dr. Kirsten Severson: Very much so. 

[00:07:20] Pete Waggoner: And then you can have stronger secure decisions or you trust. 

[00:07:24] Mike O’Connell: You bring up a good point in that too, that many people know I was a paramedic in that and being a border cities where we are, you can have a advanced directive at Hudson hospital, Baldwin hospital, anywhere in Wisconsin, but when you get shipped to United.

[00:07:41] All that’s worthless. Am I right? 

[00:07:43] Pete Waggoner: Oh, no.

[00:07:44] Dr. Kirsten Severson: As far as the POA for healthcare, the power of attorney. Yes. But where I hinted before that the living will is kind of the frosting on the cake. The living will is an absolutely open blank journal for us to write down what my wishes [00:08:00] are and how I want it to look like.

[00:08:02] And so that’s where a lot of people will say after 3.6 weeks, then take this away. Or after five months, then don’t do this. But a very gifted and insightful patient of mine turned it backwards. And instead of don’t do CPR, don’t do feeding tubes. Don’t do antibiotics. She defined what living meant to her in the warm, fuzzy way of, I wanna feel the snuggles from my dog and the hugs from my great grandkids.

[00:08:31] And she finished this beautifully written idea by saying, if my healthcare team can’t promise that given tests, given treatment will provide this quality of life. Then please respect me and say, no, thank you. And it was a very well written, interesting approach. And so that living will is kind of the recipe for you to discuss with family, your [00:09:00] friends, your agents, as to what they should say, if they are given the privilege and responsibility of being your voice. 

[00:09:07] That document is not a check box, you have to do this, have to do this, have to do this. And those general ideas can be transferred across state lines. And it’s kind of that guidance for that voice. If you haven’t had the opportunity to vocalize with them. And that’s the biggest challenge. 

[00:09:26] Pete Waggoner: So how, where, who do I go about if I’m someone listening to this podcast and I wanna get an advanced care. Where do I go? 

[00:09:35] Dr. Kirsten Severson: Yay. The easiest I think is to go right to your provider, your doctor, your nurse practitioner, and say, Hey, I heard this weird thing. That’s out there. I want to give it to me. And, and each clinic should have a, a click button off of their computer. They can print it. There are in Wisconsin websites and, and the great one is [00:10:00] if you simply Google search Wisconsin DPOA healthcare, and it brings up a DHS form sheet, and that form online, you can print the power of attorney documents.

[00:10:13] You can print advanced directives. You can print your living will, and you could even go as far as printing a DNR form, which is a very different conversation, different type thing, but DHS is hard to maneuver, but if you Google Wisconsin DPOA healthcare, boom. It pops right up done. 

[00:10:32] Pete Waggoner: Okay. Yeah. So then where do you submit, does it give you directions within that website now that you’ve done this?

[00:10:39] What do you do with ’em? Do you mail ’em in, do you take them in, do you upload. 

[00:10:43] Dr. Kirsten Severson: You hit the magic print button. And you can print as many times because the magic of this is it’s a very fluid document. And so people, when I’m talking to like a 24 year old, they freak out because they’re afraid that as soon as I sign that dotted line, that I’ve lost all control with my own voice.

[00:10:59] [00:11:00] But then I want people to understand this is almost like a, he an insurance document for your health. We all have to PA have insurance and we hope we never. But by golly, when you need it, you are so thankful that it’s done. And so you, you print this document today in 2022, and let’s say something changes five years, two months, 20 years from now, you simply rip up that current document and start all over.

[00:11:25] Pete Waggoner: No different than changing a deductible. So if you’re saying, you know what, I don’t like where this is at. Let’s change it. You’re not locked in. 

[00:11:30] Dr. Kirsten Severson: And you don’t need lawyers, you don’t need notaries, so it’s a very easy process. Yeah. So once you print these papers, what you do is take them to your healthcare provider. They are going to put it in the clinic chart, the hospital chart. And I encourage people to take it to each of their specialists. So if you have a heart doctor or a lung doctor, or you go to this hospital or that hospital, because not all of the electronic records talk.

[00:11:56] Yep. But you wanna keep it in your paperwork. You wanna give it to [00:12:00] your agent. So they know. Been given this potential responsibility and then you just know where it is. In case of.

[00:12:07] Pete Waggoner: Michael, did you have such a document when you went in? 

[00:12:11] Mike O’Connell: Well, I was just gonna say, when there’s a crisis, that’s not the time to be looking forward, first of all, or thinking of it because there’s a crisis.

[00:12:19] Mine wasn’t a crisis, but when you’re sitting in a hospital bed, they’re getting the IV and they look at you and they go, do you have advanced directives? If you stop breathing, I’m like well, why would I stop breathing? No, I mean, why would we talk about this? So it’s not the time to do it, then you wanna be proactive and do it when you’re clear of mind and emotions are like the doctor had taken out of it.

[00:12:37] One question I have Dr. Kristen is, do you foresee a time where that the medical records of the hospitals will play nicely and communicate better? When I went to my first doctor for my cancer, I was taken back because here, I don’t know if I’m living or dying and I get there and a, he hadn’t even looked at my [00:13:00] file, but he didn’t even get my CT scan.

[00:13:02] And he asked for a CD bra of it, which to me was a joke. But they said, well, our systems don’t, you know, communicate very well. At what point will they communicate? Or is that something that’ll just never happen? 

[00:13:15] Dr. Kirsten Severson: That’s the million dollar question. However many years ago, the government made each healthcare entity move to an electronic record with the idea that within months, everybody across the nation would have connections.

[00:13:30] It is not there yet. And that was years ago. 

[00:13:33] Pete Waggoner: I know in 2006, someone specifically hired to train epic, for example, still doing it in 2022. And so to real time, real life, that’s just one program. And that doesn’t mean that hospital ABC and EFG are two different places, have the same one. And then you gotta get those to talk to ’em.

[00:13:53] Then you get into the computer world inside baseball, we’re talking APIs. They gotta figure it out. Yes, please. People like, get it on the [00:14:00] same page. The whole, do you find this? I don’t mean to turn the, into this discussion, but I find this part fascinating. In today’s day and age, it, it needs to be a little more organized and someone needs to take charge.

[00:14:15] Who that? Do we know? I mean, that’s the tricky part. Let’s do another podcast on that one. 

[00:14:21] Dr. Kirsten Severson: Yeah, exactly. okay. That’s great. Love it. We’ll do it as after five o’clock. 

[00:14:24] Pete Waggoner: By the way Michael Kristen is one of the smoothest talking guests we’ve ever had. So this has become the easiest podcast I’ve ever done.

[00:14:32] Wouldn’t you agree? 

[00:14:34] Mike O’Connell: She’s a piece of cake. Yes. 

[00:14:36] Pete Waggoner: Yeah. I I’m unbelievable. We start this thing and she’s like, can you edit? I’m like, sure, no problem. I’m like, oh boy, here we go. No, I’m not really, but you never, most people that ask that just are silky smooth. The ones that don’t, you have to edit. So good job.

[00:14:49] You’re doing great. Okay. I’m a big, I’m a big believer in positive reinforcement.

[00:14:54] Mike O’Connell: Okay. Do you remember in the eighties when we had the vial of life, so you’d get the EMS [00:15:00] call and you’d go to a house and you’d say, where’s your refrigerator? And you’d go to it because some people would have their instructions in a tube and your refrigerator, cuz it was a common place to go.

[00:15:10] Dr. Kirsten Severson: Absolutely. And now I pick on that because I tell people that everybody’s so mobile and nobody wants to stay home anymore. And you can’t take your refrigerator to the park or the theater.

[00:15:19] Pete Waggoner: Yep. So on, on that topic real quick, we were, we were talking a little bit about where you store it or who you share it with.

[00:15:26] We’ve sort of touched on this a little bit earlier, your immediate doctor should know about this or have access to that as well. And then as well with. Immediate family. And those types of people are, are, who might need to know maybe it is the refrigerator or wherever you put it, you know, who knows?

[00:15:42] It just depends whom you are, but who else do you share it with and where do you put it? Typically? 

[00:15:48] Dr. Kirsten Severson: I tell people that these documents should be photocopied a million times over. So wherever you keep your documents in the folder at home, all of your agents, any of your [00:16:00] family members, any of your doctors’ hospitals that you have contact with.

[00:16:03] And then I think the magic of it is, is to keep a master list of where these piece pieces are. Yep. Because if you change your mind down the road, you don’t want all of these old documents, someplace. And so if you move, you can contact that entity and say, you know, it’s a moot point. It’s destroyed. Here’s a new copy. 

[00:16:23] But there’s nothing other than just moving them. Couple other weird thoughts. I have with some of my people who winter in other states, or do a lot of traveling, there’s absolutely no reason why you should not keep those in your Hmm. Suitcases or your vehicles. Not necessarily that it’s legal document in wherever you are, but it gives hints and ideas to open the door.

[00:16:46] If that crisis comes, when you’re in utah. 

[00:16:49] Pete Waggoner: Well, and in many instances you’re not afforded the luxury of time. So that’s super huge.

[00:16:55] Mike O’Connell: And emergency medical staff, as well as the doctors that do not know a person [00:17:00] do not have any documentation or forced to do everything they can, which might be against everything that you wanted, but they don’t have the paperwork.

[00:17:08] Dr. Kirsten Severson: Okay. Do you wanna talk about that conversation? That’s an easy one, truly. And when it comes to a decision that, and, and correct me if I’m wrong, Mr. Mike. Everybody is medically obligated to do more than less. And so if nobody is aware of anything, everybody is going to be given full court press until some of these documents can be produced and proven.

[00:17:31] And sometimes like you hinted it’s way too late.

[00:17:35] Mike O’Connell: You’re intubated on a CPR. You didn’t want that. And now you’re on, you know intubated. They find the paperwork and now you have to pull the plug and that just is traumatic to a family. That they didn’t wanna have it, but they had to have it because the paramedics didn’t know and the ER didn’t know.

[00:17:53] Dr. Kirsten Severson: Exactly.

[00:17:55] But now we have an answer for that. Here’s part two. For the [00:18:00] individuals who truly at age 40 at age, 140 say absolutely under no circumstances. Do I ever want that trauma? I don’t care if it’s tonight and, and I give people in the clinic, the example right now, we’re talking if your heart stopped and you’re on the floor dead.

[00:18:18] What do you want? And if people say right now I’m ready to stay dead and be dead forever, then Wisconsin has kind of a, a newer program compared to the refrigerator, that orange sticker in the freezer where you could actually register through the state and have a physician sign, a document that makes it legal order to never resusci.

[00:18:38] Me and that magic is that once you do that, then you wear a bracelet 24 7, and that should protect you in the state from anybody making a best effort at resuscitation. And so they will still come because everything always happens in the grocery store someplace embarrassing. And everybody’s gonna panic.

[00:18:59] [00:19:00] They’re gonna call 9 1 1. But when they see that bracelet, they will do their full assessment. They’ll make sure that there is heartbeat, no breathing. That’s not, oops. I tripped and, and broke a hip or I had a seizure or a stroke, but if a person is truly dead, they will see that bracelet. Of course, they’re gonna give you a blanket and a pillow and make you look comfortable so that the rest of the community doesn’t freak out, but they will not start CPR.

[00:19:24] And so on that website with all the magic forms from Wisconsin, that form also can be downloaded. And then brought to your doctor. The doctor talks with you, make sure that everybody’s on the same page and then gets you help to get that bracelet. 

[00:19:38] Pete Waggoner: So this plays into the question of legally binding and then we hear so many times where.

[00:19:45] This family member’s saying no, we’re gonna give them every possible opportunity for life. That’s what I want. Even though this may exist, what happens there? I mean, it must be legally binding, right? 

[00:19:58] Dr. Kirsten Severson: With the DNR do not [00:20:00] resuscitate bracelet program because the physician signs, it’s a physician order. And so, as long as I, or grandma or uncle has that bracelet on them, that’s a physician’s order. And so no matter who is around, they should not be able to override that wish. 

[00:20:17] Pete Waggoner: Got it. Now Michael touched on this a little bit ago. Let’s say if something happens outside of the hospital and you have an advanced directive, but how is paramedic or anybody that’s a first responder to know. Does that get a little, I mean, there’s just nothing you can do. Is that pretty much, what’s the deal there, unless, if you have no communication of this and you’re on the ground, what happens there? 

[00:20:41] Dr. Kirsten Severson: The hope is that if my feelings are so strong that I don’t want any kind of resuscitation, that I would have that bracelet, that’s kind of, at least in our circles.

[00:20:51] That’s the newest conversation. It’s really about that because really until that time paramedics are going to do what they can, because my [00:21:00] heart is still beating. And so I will be treated. And then usually where these advanced directives come in is, oh my gosh, something really horrible happened to grandma.

[00:21:10] Now, tag, you are the decision maker. Do we go on with heart surgery? Do we go on with dialysis? And, and it’s the bigger long-term questions rather than the immediate, do I start a hard or do I not? 

[00:21:23] Pete Waggoner: Well, so michael, when you…

[00:21:24] Mike O’Connell: Could I jump in there, Pete? With technology today, though, the ambulance services, especially in a small town, let’s say Hudson or river falls Baldwin.

[00:21:33] If you are,

[00:21:36] whether a frequent flyer or not, you can give them that directive and they’ll put it in their computer. And if that address comes up as a chirp on their system, they can pull it up on the way there. And so, I mean, that’s technology, right? That’s awesome. So that wasn’t there 30 years ago, but it is today.

[00:21:54] How does it work every time? I, I don’t know. I’ve been out of the field for a while, but there is advancements every [00:22:00] day going on for better communication. 

[00:22:01] Pete Waggoner: So that was my question. I was gonna say from the paramedics perspective, is there any data information they can access what you’re saying? As of now in a controllable community environment that maybe isn’t as big as something like Minneapolis or St. Paul. You know, which maybe could happen there too. Certainly sounds like there is. And then just, can you touch on a little bit though from your first responder perspective, you know, you get there, you wanna save and help, right? I mean, that’s really what you’re doing is that tricky on that perspective?

[00:22:31] Mike O’Connell: Come at it again. A little different, what’s your question? 

[00:22:33] Pete Waggoner: Is it hard to just say, okay, we’re done. When someone says I wanna be done and you know, you can maybe do something as a paramedic?

[00:22:39] Mike O’Connell: Absolutely no. Okay, if it was something acute. Absolutely. But if it’s chronic, and you can see the patient that, you know, putting them through that is gonna be traumatic.

[00:22:49] It doesn’t increase their chance of living much or their longevity or quality of living. And you’re looking at the family, then that’s an easy decision. Now, if you have somebody that just, [00:23:00] you know, thought, well, I don’t, I’m gonna, you know, live another 30 years. And so, but if something happened to hell, no, I don’t want that.

[00:23:06] And then something does happen to ’em and their family is crying, but yet you got a paperwork that said he didn’t want CPR and he’s 50. Yeah. That’s hard. Absolutely. 

[00:23:16] Pete Waggoner: So Dr. Severson you’ve been on the front end of a lot of these conversations. How do I start that with you? How does it begin? Or how do you start it?

[00:23:22] Dr. Kirsten Severson: Oftentimes patients don’t initiate it. And so I’ve made it a habit of mine for either brand new people that I’ve met or the one see or physical. We ask any med changes. Have you been immunized for flu and et cetera? Tell me about your advanced wishes and what are your end of life goals look like? It just rolls off my tongue and it surprises a lot of people.

[00:23:45] But hopefully is something that’s getting more and more common that we can talk about. Nobody is afraid to talk about it. We’ve got a long ways to go yet. But it should be just a part of your, your general healthcare. 

[00:23:57] Pete Waggoner: There are tricky conversations to have I’m sure.[00:24:00] 

[00:24:00] Mike O’Connell: Have you ever seen… the bracelets, right? Medical bracelets? Have you ever seen one that said I don’t wanna be fo. I don’t wanna be fully because here here’s why, if you wanna know the, so I’m going under surgery and they put me under and somehow they must have been shorthanded or something. They ran down to the landscape, you know, department, whatever department of the hospital.

[00:24:25] They grab a 30 foot garden hose and they used it. Mm-hmm and that was my fo catheter on a garden reel. Holy man. I didn’t like that. I’d rather be intubated than have a Foley catheter stuck in me again. Ouch. Oh my that thing was like 20 feet long. Doctor can’t we come up with something easier?

[00:24:46] Dr. Kirsten Severson: I’ve never offered that to somebody, but I could put it on my list. You want intubation? Do you want a feeding tube? Do you want dialysis? Do you wanna Foley? 

[00:24:54] Pete Waggoner: There you go. What are the options you can have? Like what can you ask for? He just asked for one, that’s an option, right? 

[00:24:59] Dr. Kirsten Severson: Ranking [00:25:00] straw or a garden hose. 

[00:25:01] Pete Waggoner: Okay, perfect. And then what else is there, I mean, what other options are there for you to request for your end of life wishes that you’ve seen that are common maybe? 

[00:25:09] Dr. Kirsten Severson: Really it’s truly what my ideal world would be is to have it that fabulous phrase that everybody uses in healthcare now is patient centered conversations because it’s so different. And oftentimes I’ll say it. The easy question is resuscitate me, or don’t mm-hmm, either plug me in or you don’t. However, most of us through our healthcare don’t have that luxury of a black and white.

[00:25:34] And so let’s pretend I work with a lot of people with memory problems, and that’s probably the hardest thing to think and plan out. But that person, you know, I, I would rather talk to your healthcare provider and say, what are my health concerns? If it’s lung cancer, what is that road gonna look like?

[00:25:50] I’m gonna be short of breath. I’m gonna be less active. I’m gonna have chest pain. I’m gonna have a lot of anxiety because I can’t breathe. So how can I anticipate those questions? [00:26:00] If I have dementia, memory loss. I’m gonna be physically fine, but I’m going to forget to eat. I’m gonna forget to drink. I’m gonna get recurrent infections.

[00:26:11] So my questions there are, do I want to feeding tube? Do I want somebody to give me IV fluids every month? Do I want somebody to keep treating infections? If if they keep coming back, if I have. Bleeding problem. How many blood transfusions do I want before I say enough is enough? And so all of those are questions that are legitimate and really should be thought about, but instead of just blanketing everything, you know, look at what I’m dealing with and help me with that decision.

[00:26:41] Pete Waggoner: Got it. 

[00:26:41] Mike O’Connell: You hammered over the, the years we’ve hammered that haven’t, we. Preplanning talking, and don’t putting that on your family. This is even amped up even more than that, that if you don’t do some of these things, you’re asking them to play little godlike because they are then gonna have to make the decision of [00:27:00] live or die.

[00:27:01] And if you don’t want that, that’s why you do this. And I would, and maybe the doctor would be saying this hereafter, but if you don’t have a relationship with your doctor, I mean, Pete, can you imagine, Dr. Kristen, it’d be so easy to talk to her about this stuff. You wouldn’t feel threatened.

[00:27:15] You wouldn’t feel awkward. If you have a doctor that you’re comfortable with, this is not a difficult decision or discussion. But maybe if you don’t have a doctor, find one. Yes. And let’s start that relationship. 

[00:27:28] Pete Waggoner: Well, and if I may, you’re absolutely correct Michael. And how we’ve hammered on that topic.

[00:27:33] And, you know, I didn’t even think of this at all. I didn’t know. It really. Never even knew it was. I know you hear about the do not resuscitate stuff and whatever, and you know, that could be long term patients or whatever care facilities and stuff. But what really is interesting, what I think has been kind of my mission to hammer on with Michael here is now we’ve got, what are you gonna do with this? After people pass away, that’s explosive enough as it is when they die. [00:28:00] Right? But this is even more intense before. So put those two together and we’re talking combustible, right? So why wouldn’t we take care of those we love and do it the right way. 

[00:28:12] Dr. Kirsten Severson: Absolutely. And like, you guys hinted, it’s not necessarily my choice. And I hear this so often. I don’t want to starve dad. I don’t want to kill them by not feeding by not doing. But in reality, if we’re at that point where our bodies are so weakened, we’re already on that last chapter of death. And how does it want to be? Does it wanna be traumatic with IVs and tests and pills and treatments, or does it want to be natural where I can be in an environment that I want, and those decisions from those agents then are an honor to what my life has.

[00:28:52] They’re honoring my final wishes and saying, this is what it’s going to be.

[00:28:58] Pete Waggoner: Well, so the irony is you may [00:29:00] be physically starving them in this life, but you could be starving ’em from their next steps, no matter what you believe. While you think you’re doing well. But this all answers any of those questions, whether you agree with them or don’t agree with them as a family member and you may do something completely different.

[00:29:16] That’s really, but it comes back to, you said it’s your decisions? Yes. 

[00:29:20] Dr. Kirsten Severson: Can I hint one more thing because that, that whole emotional piece of I’m starving, I’m killing my loved one is so difficult. And it’s hard for those of us who are good Midwestern Norwegians. We don’t talk about emotions.

[00:29:34] Life’s fine. It’ll deal with itself. There are a couple other websites that really open up the warm, fuzzy part of this conversation that really make it practical. It’s not medical this procedure, that procedure, but it helps open up. How do I even talk to my family about this? One of them is a collection of videos that people actually interviewed people going through this process.

[00:29:59] How [00:30:00] did I do it? What made me do it? And it’s considered the It’s a warm, fuzzy of actual people. Who’ve done it. And then that same group who put the time into that research, took it one step further and made about. I dunno, six to 10 pages that are almost like a workbook, and those are the probing questions of, oh, I never thought I should think about it this way.

[00:30:25] And it helps make the conversation around the Thanksgiving table a little bit easier. And that one is the And that one, you can hit the print button again, and it’s just things about how important is pain control. How important is alertness? How important is where my death happens to me and how can I make it work?

[00:30:48] And so those are not legal patient papers. It’s just a matter of what and how do I, where do I start thinking? 

[00:30:55] Pete Waggoner: So we will take those web URLs and we’re gonna place them in the [00:31:00] description. Perfect. And we’ll put, where do I start perfect on there. And then we’ll put the, the, the you’ve named three or four of them mm-hmm here.

[00:31:07] And then earlier, too, as well, where you get all the documents in those things. Yes. So we’ll make sure we get those posted. So people have easy reference. So if you’re grabbing your pen or hitting pause and then rewind, don’t worry about it. It’ll be linkable too. I’m sure. From within the description, imagine that technology works so.

[00:31:24] And you’ve kind of gone through the good resources with that, you know, I mean, it wouldn’t be terrible for someone that’s listening here to go ahead and start taking looks at these things and then come to you or their doctor, and then continue the discussion. 

[00:31:39] Dr. Kirsten Severson: And there’s one magic piece. I want to say, maybe in the last three years.

[00:31:43] And I’ll stereotype and say that a lot of this activity really ramps up when people get grown up. Medicare in the last few years will now accept this as a reason for a medical visit. Oh, really? Yes. So if you’re worried about copays and [00:32:00] deductibles. Now Medicare says, well, if you’re going in for a cough, we’ll cover your 80%.

[00:32:04] They will cover their usual 80% for this kind of a conversation with your provider. And so you can go in for your normal visit with this being the goal. Hey, this is what I’m hearing about. I don’t know where to start and your provider can talk with you and that can happen as many times as you need it.

[00:32:22] They can help you go over your documents, making sure that you know, what you’re agreeing to, they can kind of guide your healthcare and look down the road. What might it look like? Think about this. You can have those conversations every month, if you need to. And the hope is that you go over these kinds of conversations, at least once a year.

[00:32:43] Like you do your financial pieces, like you do your insurance pieces, but then if there’s a major health change. Oh my goodness. Now I have a stroke or now you’ve diagnosed me with heart disease. That’s a perfect time to stop. And re-look, what’s new in your [00:33:00] wishes now compared to a year ago. 

[00:33:02] Pete Waggoner: They may have changed too.

[00:33:02] Dr. Kirsten Severson: Absolutely. It’s it’s a fluid conversation. It’s not a one and done thing. 

[00:33:07] Pete Waggoner: Back to a earlier point where it’s not etched in stone. And you can adjust and change things and move things around as needed. 

[00:33:14] Dr. Kirsten Severson: Absolutely. 

[00:33:15] Pete Waggoner: That is fantastic. 

[00:33:17] Final question for you and Michael When you, when you look at the people that have taken advantage of these directives, do you find the process, Michael much like preplanning, to be a lot easier?

[00:33:32] Not only on you professionally, but also on the loved ones who are in the grieving process and trying to work through it as compared to those that haven’t. And then there becomes this just wicked. Can you kinda talk about how much this makes a difference? 

[00:33:52] Mike O’Connell: Who do you want that name that? 

[00:33:52] Pete Waggoner: Whoever wants it, go ahead, Michael.

[00:33:56] Mike O’Connell: Well, yeah, excuse me. Absolutely. Without a doubt, when [00:34:00] you take the emotions out of somebody, these tough decisions, and you know, you’re doing the patient right by a right by them. It helps you put your head in the pillow, knowing if you’ve done a good job and you’ve taken care of that person. What they wanted.

[00:34:13] So resounding yes. 

[00:34:15] Pete Waggoner: Good stuff. You can’t go wrong with that. For either of you, any closing comments before we wrap up this most fascinating and information late in podcast we’ll start first with you, Dr. Severson. 

[00:34:26] Dr. Kirsten Severson: I can always have comments. No, I think my big thing is look ahead and we know that death is coming for all of us.

[00:34:33] And so don’t be stupid and close your eyes and hide from it, make it what’s important to you, and that makes it not only easier for you, but it makes it easier for your family when that time comes. It can be a celebration of a living life instead of a panicked. Oh my gosh.

[00:34:48] Pete Waggoner: Michael O’Connell? 

[00:34:50] Mike O’Connell: Exactly what she said. And don’t put that burden on your loved ones. 

[00:34:54] Pete Waggoner: That’s what we’re trying to get to here. Both of you. Thanks for joining us during your busy schedules here today [00:35:00] for another edition of good grief, the podcast from the O’Connell family funeral homes, be sure to check us out at o’ And you know, Mike, we’ve got a ton of great stuff on social media for people to be engaged and involved with your your great work that you do in the community as well.

[00:35:15] So be sure to check out all of those channels as well. Michael, continue your road to full speed ahead. And we’re really happy to hear things have worked out well for you. And thanks for jumping on the phone with us here today. 

[00:35:28] Mike O’Connell: Absolutely. And Dr. Kristen, and I’ve done this personally with you, but you are a great advocate and ambassador to your patient and you are a blessing to the community all day long.

[00:35:37] Dr. Kirsten Severson: Hey, thanks. Right back at you.

[00:35:39] Pete Waggoner: Dr. Severson thanks for coming in. Great stuff. We appreciate it. For Dr. Kristin Severson and Michael O’Connell I’m Pete Wagner so long everybody.