Kokua Mau: Hawaii Hospice and Palliative Care Organization

Written by Sunrise on KGMB9 - sunrise@kgmb9.com

April 14, 2008 10:31 AM

Today marks the start of Hawaii healthcare decisions week, part of a massive country-wide effort to highlight the importance of advance care planning. Wednesday is National Healthcare Decisions Day. Dr. Thomas' guest this morning is Rachael Wong, of Kokua Mau, the Hawaii Hospice and Palliative Care Organization.

DR THOMAS: This morning I’m sitting down with Rachael Wong from Kokua Mau, and we’re going to talk about the very interesting fact that everybody realizes but no one really talks about that, and that is people don’t live forever.

RACHAEL: That’s right.

DR. THOMAS: We all like to think that maybe we’ll live forever, but the truth is, no. And so you work with the Hawaii Hospice & Palliative Care group, and what’s that like?

RACHAEL: Well, thanks Bill, for having us here. One of the things that we do with Kokua Mau is advance care planning. You know in addition to hospice and palliative care and bringing all these organizations together, advance care planning is much broader than just completing your advance directive.

DR. THOMAS: Well, here’s the thing. I’m a geriatrician. I spend a lot of time with older people. And actually have spent a lot of time talking to older people about their death, and how they want to die, and what they want it to be like. Is that a conversation you guys are involved in?

RACHAEL: It is, and it’s a conversation not only with an older person, but with families as a whole. As you mentioned, death has a hundred percent incidence rate, that’s right. Death and taxes.

DR. THOMAS: (LAUGHS) …a 100% success rate.

RACHAEL: And so what we do is we want to encourage families to give this gift of planning to each other. You know we plan for our kids’s college tuition, and we plan for retirement and the trips we’re going to take. But one of the greatest gifts we can give to those who we love is to plan for how we want to be cared for at the end of our life, when we can no longer speak for ourselves. Who is going to speak for us? What kind of care and treatment do I want.

DR. THOMAS: Yeah. You know those are really big decisions and I know a lot of people watching this have been in situations when somebody they love has been really sick, and nobody knew what to do, nobody really knew what Mom wanted. Sometimes, you know, there’s fighting among the family and it can be a disaster. At the same time, sometimes you see beautiful, beautiful things happen. I mean, tell me about that.

RACHAEL: Well, actually, I work in this field but I can also speak from personal experience. And our family actually went through this, and I’ve lost four grandparents, who have all gone under hospice care, and received wonderful care and good deaths. And also a young brother-in-law, who last year died of cancer, and you know he also experienced a good death under hospice care. And because he had prepared so well. You know he and my sister had completed their advance directives. They had put things in order. So, when the time came, everybody knew what his wishes for care were.

DR. THOMAS: And if I may say, not only that, but you’ve experienced really severe chronic illness, and been at a point where you’ve had to look at your own death. And, we were chatting before. You were mentioning that so many people misunderstand and think that the compassionate thing, the kind thing, is not to talk about it. And yet you were there. I mean you were in that situation. Share with us, I mean, how it felt to you.

RACHAEL: Sure. And I need to say in Hawaii, we’re so diverse with all our different cultures, but so we do have a lot of cultural taboos. There’s barriers to talking about end-of-life care and death and dying. And that’s something that we as a community need to put on the table and speak about.

DR. THOMAS: Absolutely. I mean it’s universal. It’s coming down the pike for everybody. And the more we plan and the more we talk, really the better it is for everybody.

RACHAEL: That’s right. And for me personally, you know, I lived with, I was diagnosed with lupus 17 years ago, um had slow kidney problems and ended up with end stage renal disease on dialysis. And it was a gradual progression for me realizing my own mortality, and I still having this awareness. I’m one of the lucky ones that received a kidney transplant six years ago, and so have gone from living on the edge as you phrase it, to being healthy. But it’s still as relevant as it ever was.

DR. THOMAS: Well, thank you so much for the work you do, and the kindness and compassion that you bring to the kupuna of Hawaii, and may your work be blessed.

RACHAEL: Thank you. Thanks for being here.

Rachael Wong, Executive Director, Kokua Mau
Hawaii Hospice & Palliative Care Organization

Free downloadable advance directives at:

Kokua Mau

www.kokuamau.org

(800) 474-2113

(808) 585-9977

Last Updated ( April 14, 2008 10:31 AM )

County Agencies on Aging Senior Helplines
(For all information and resources related to aging and caregiving)

Elderly Affairs Division, Oahu
Phone: 768-7700
www.elderlyaffairs.com
Hawaii County Office on Aging
Phone: 961-8626
http://www.hcoahawaii.org/
Kauai Agency on Elderly Affairs
Phone: (808) 241-4470
http://www.kauai.gov/elderly
Maui County Office on Aging
Phone: (808) 270-7774
http://www.co.maui.hi.us/departments/Housing/aging.htm