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Episode 16. Retired...or Rewired?
Viki Kind   Viki Kind is a clinical bioethicist, professional speaker and hospice volunteer.  Her award winning book, The Caregiver’s Path to Compassionate Decision Making:  Making Choices For Those Who Can’t, guides families, conservators and other professionals through the difficult process of making decisions for those who have lost capacity. Her newly released book, The Caregiver’s Path:  Resource Workbook, Conversation Guide and Visual Toolkit, provides uniquely designed communication tools for managing challenging conversations such as evaluating danger and risk, managing guilt and denial, end-of-life decisions, and helping the family know when it is time to create a new care plan.   Viki is known as “The People’s Bioethicist,” because she bridges two worlds, that of the health care professional and of the family struggling to make the right decision.   We asked Viki to discuss the following issues:  What does that term mean, “clinical bioethicist?”  What does it mean to be old?  What’s your age cut-off for elderly?  Describe a typical situation in which you engage as a service provider.  What’s the setting and who are the principal players?  Your focus is not only the elderly, you deal with cognitive impairment, dementia, stroke or other cognitive impairments.  Is that right?  How much of your work deals with elderly?  You mention four tools to use when making the difficult life, health and end-of-life decisions.  Tell us what they are and how you use them.  How do you (or how does a family member) know when to step in versus stepping back and letting people make their own decisions?  What are the specific questions to ask and strategies to use to make good decisions about CPR, feeding tubes and other end-of-life choices?  What is the 4-step process that you suggest caregivers use to get the support they need in making tough decisions?  End of life treatment is often a very expensive time….How do you help the patient and family to make meaningful end-of-life decisions while spending money on what really matters?  What are the “right questions” to ask near the end of life and how do you discern what the doctor is really saying?  Do you ever withhold the truth, or lie, with patients or family?  How do you deal with feelings of guilt associated with end of life times?  You say there are simple tests to determine “What’s the Right Thing to Do?”   What are those tests?
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