February 4 Forum

Walt

Bill, I wonder what you’re thinking the best practice would be if you could have your dream fulfilled.

Bill B

One of my students used to work in a Sutter Hospital, where there was a separate unit that had to do with health psychology, where they were dealing with exercise, medication compliance, depression, and anxiety. There was a whole unit of the hospital that was addressing these issues.

And it wasn’t just, “if you’re interested, we can get a behavioral medicine person to meet with you.”  There was much more than that.  And so, in some sense, the image I have is of an expansion on the annual wellness visit. What if a part of that wellness piece is that you sat down with someone who serves in a late-life doula role.

I now meet with my primary care physician, and we have the checklist like you were talking about. But what if I met with someone who provided a broader checklist. I would like to meet with them to talk about items on the checklist.  And if Jack’s right. If everything on the checklist relates to support and services provided by my neighborhood, my family, that’s terrific. But what if the checklist leaves off stuff? What if some items on the checklist cannot be served?  Things about which I don’t have someone with whom I can work. Would there be some evidence of impact if I worked on some of these issues? This work might increase the possibility that I remain well, that I don’t have to consume huge amounts of dollars in treatment. My physician isn’t going to get a call from me every three weeks about the latest problem I’m having.  However, if we go back to what Jack’s talking about, perhaps instead of a doula, we build or help people find or build that community, family, neighborhood and everything to support.  Perhaps we don’t need the late-life doula.

Jack

Bill, you talked about what it is that we value. Your bucket list, what do you want to get done with this list?  What do you keep?  What do you get rid of?  And I’m just curious how we help people not accumulate stuff rather than activities. It seems like we’re talking about what happens as we age. During the last ten years or so of life, we want to get rid of all of our stuff and do a whole bunch of activities. Fulfill a bucket list. Maybe we should reverse those during our life. We should be composing our bucket list of things we want to do rather than accumulating a bunch of stuff we’re going to have to get rid of at the end of life.

Bill B

Jack, I want to challenge that notion of possessions. I’m going to push against you because I think you’re defining possessions in a kind of materialistic way. Possessions can be things that are a picture or a memory. For instance, there is the whole issue of where my memories are from my life that I’d like to share with my children. And when do we have time to talk about it.  What is that about?  So, the possessions could be something that’s not material.