MEDFORD — Medford High School was the spot for conversations on living and dying well Tuesday night during The Convenings, a special program featuring music, conversations and storytelling.
Tuesday’s event was part of launching the Honoring Choices Minnesota Advance Care Planning program for Faribault and Owatonna, an initiative providing education and support to individuals and families participating in advance care planning, conversations, and completing an advance directive that allows a person to let family members and medical personnel know about his or her decision about end-of-life care.
Honoring Choices Minnesota Advance Care Planning is funded by Faribault Area Hospice Foundation, Owatonna Hospital Foundation and Federated Insurance.
Sparking conversations that lead up to completing advance directives is “a big statewide push,” but “we’re one of the first out-state communities to do this,” said David Albrecht, president of Owatonna Hospital. “In our community, probably only 10 to 15 percent” of individuals have advance directives in their medical files.
“That’s pretty low,” said Albrecht.
Lacking advance directives can be frustrating for medical staff, who don’t know the wishes of the patient concerning end-of-life care, he added. For example, though patients might not want to be kept alive by machines or have heroic measures undertaken to try and save them, that’s exactly what will happen unless they indicate otherwise.
Dr. Robert Speckhals, who practiced internal medicine in Faribault for 44 years prior to retiring in 2004, concurred.
“We found we can prolong your dying, but we can’t always prolong your life, and that is powerful,” he said, then added, “Dying is a taboo word, but we should be talking about it, Talk to your family about death.”
Amy Selly, an oncology nurse practitioner at the Virginia Piper Cancer Institute at District One Hospital, echoes those sentiments Tuesday, noting, “We are all afraid of dying.”
“Society has stigmatized dying,” she added. That’s one of the reasons it’s difficult for people to accept hospice care, even though “you can live well on hospice.”
There are two Honoring Choices Health Care Directives, a traditional, comprehensive, eight-page-long document leading individuals through medical, spiritual, and personal choices, and a short form that is new and simple, allowing one to name an agent and list basic health care wishes. An agent, also referred to as a proxy, is the one entrusted to make decisions for a person if he or she cannot make those calls.
While an attorney is not required to complete health care directives, it must be in writing, with full name clearly visible, signed, and dated. In addition, the directive must list a health care agent and/or healthcare treatment instructions, and it must be witnessed by two adults or a notary public.
Tuesday’s event was also spurred on by the book “We Know How This Ends: Living While Dying,” a finalist for Minnesota book of the year in the memoir category, which chronicles the life of Dr. Bruce Kramer, who died in 2015 following a nearly five-year battle with ALS. The book was co-authored by Kramer and Minnesota Public Radio journalist Cathy Wurzer.
The Convenings “is a gathering we think is unique in Minnesota,” Wurzer said. The program utilizes music, passages from books, interviews and audience participation so those present “reflect on your life and how you want it to end.”
Her work evolved into a wonderful friendship with an amazing man, Kramer, who “lived a remarkably full life” despite a debilitating disease, she said. With death so near, life is drawn into clear and sharp perspective.
As his body deteriorated, his mind sharpened, Wurzer said. “The disease kept taking from him” physically, but he grew sharper emotionally and spiritually.
Kramer “was very much about choices and possibilities,” and the first of those choices was to be very public with his ALS, said his friend, Deb DeMeester, a director of leadership development for the Synod of Lakes and Prairies in the Presbyterian Church, a founding board member of the Bruce Kramer Collaborative, and a part of Kramer’s support system as he battled his disease.
“He continues to inspire everything we do,” DeMeester said.
Kramer “believed in the power of possibility,” Wurzer said. Holding the reality of his death in front of his face every day led him to rearrange his priorities.
Because Kramer loved music so much — he possessed a sublime singing voice and was a choral director — The Convenings included several musical interludes in his honor. Mark Allen performed a pair of songs, Rafi Dworsky sang a number he wrote while his father-in-law was dying in hospice, and the string duet of India Enter, cello, and Caroline Nelson, violin, were featured prior to the official start of the program.
Kramer’s own words were also a substantial portion of The Convenings, both played on tape, and in readings from his book by Wurtz, DeMeester, and Franchon Pirkl.
“We must ask questions that will open new horizons,” Pirkl said Tuesday, quoting from Kramer’s book. “What will you be from here to eternity?”
“Disease has taught me change is the one constant,” DeMeester added, also quoting Kramer. “I know what is important now,” and there’s no time for games, holding grudges, or being afraid to forgive.
Also Tuesday, George Dow, who practiced law in Owatonna for four decades, spoke about his wife, Jenelle, who died last summer from cancer.
“She approached the disease with tranquility,” he said. She had “no complaints.”
He also emphasized the importance of completing an advanced care directive.
“So many of us put this off,” he said. Many individuals want at least some of their estate to go to certain charitable causes, and it would behoove them to spell out those provisions, or else “it won’t happen.”
“You, not us, have to make those calls,” he said. They ought to be spelled out in a living will, and “I can’t stress how important that is.”
The goal is to “bring advanced care planning to you and make it easier,” said Kerry Hjelmgren, Honoring Choices Advance Care Planning Coordinator for Faribault and Owatonna. In the coming days and weeks, “we will be building and training a team of volunteers,” and there will be several informational and instructional events where individuals can learn more about advanced care planning and fill out directives.
The Convenings “is a special event,” Albrecht said. “It’s a good way to kick off” the establishment of Honoring Choices locally.