Welcome back to the Light Keepers podcast, an
exclusive production of A Guiding Light, our
nonprofit charity dedicated to the idea that
knowledge is power and good information leads
to a better life. I'm Clayton Vandiver, your
Light Keeper, with my co -host, as always, Charlene,
our licensed clinical social worker certified
in the state of Florida. This show is dedicated
to everyone who wants to get the most quality
out of life that they can. Join us for the conversation
this week. Part two of The Odd Couple, when the
family members just can't quite agree on their
plan of action. And so much more on this week's
edition of the Light Keepers Podcast. Please
leave your questions or comments below and join
our conversation. Questions are answered during
our next show online each Wednesday evening at
7 p .m. Eastern. The Light Keepers podcast is
an exclusive production of A Guiding Light Incorporated.
And tonight it is a continuation. We're actually
just continuing to tape this because it was so
much. We wanted to squeeze a little bit more
into that show last week that was getting too
long. We decided to just continue right on with
the conversation and talk about a few of the
things that we didn't quite have time to get
into. Now, what was our show about last week,
The Odd Couple? So The Odd Couple is, I was telling
a story about a couple that I met with recently
to talk about their advanced directives. had
opted for a do not resuscitate order. They no
longer wanted to be resuscitated if their heart
stopped. And this was a surprise to the spouse.
This was a surprise to the spouse. Okay. Because
it might have been a recent change of heart,
a change of mind, inspired by recent medical
events in their family. Change of heart literally.
That can happen. So the one question that I didn't
ask in the last show, and should have, good follow
-up question, so what do you do then as a counselor?
If they don't agree, they don't have a way to
figure this out. I know at the time you mentioned
that they had to step back and take a moment.
And you even offered to call them back, I think,
later. Yeah. And understand that... When a professional
counselor speaks with patients, you know, sometimes
it's shared little very generic details, no details
at all, very generic information about that call
is shared with me or I'm sure with other spouses,
but no specific identifying information. That
HIPAA protection, and I have to mention this
right off the bat, that HIPAA protection is crucial.
It's not only legal. it's critical to the counselor
-patient relationship that none of their information,
it's not going to be shared on this show and
it's not going to be shared to me. But she did
mention afterwards that she had to have them
step back and sort of give them a moment to think
about it, I guess. Correct. So sometimes as a
therapist, the... The meeting can be difficult,
not just for the people that are there for counseling,
but for the therapist as well. Nobody enjoys
confrontation, but in the therapeutic process,
there is a time and a place where confrontation
can be beneficial. Sometimes it's just bound
to happen. That is very true. And yes, sometimes
I use those experiences for the benefit of others
by sharing. a little bit about that without ever
sharing enough information that the person could
be identified. Right. I mean, I don't know who
these people are. I don't know their names. I
don't even know what part of the country they're
in or even if they're in this country. I don't
know what scope and scale. And I'm not going
to tell you. counseling carries i know it's it's
broad uh it's a very broad uh scale and scope
and geographic coverage when you think about
what we do um we talk with people all the time
in person over the phone over the computer and
there's i mean it could be anybody anytime anywhere
it could It could be a family member for all
anybody knows. And I would never know that. Because
God knows we've had these situations within our
own families. Right. I would never know that.
But the thing is, is sometimes the person that
you depend on the most to carry out your wishes
doesn't agree with them. Yeah. And when that
happens, you have to have a very honest conversation
because guess what? If they're not going to carry
out your wishes, it doesn't matter if that's
mom, dad, wife, husband, brother, sister, niece,
nephew, uncle, cousin, doesn't matter. If they're
not going to carry out your wishes, they need
to not be your medical power of attorney. Well,
they have to be on the same page with you. And
at the moment that you discovered that page,
those were two different pages that you were
reading. And that's a great way to put it. If
they're not on the same page, they need to not
be on the paper. Oh, they need to not be reading
that book. Yeah. Yeah. Not in the book. And these
were on two different pages. And as soon as you
realized that, you had to step away from the
book and say, you know, let's give you guys a
moment to think about this, which was shared
with me later only as one of those generic, very
general moments of my workday that, you know,
this was really challenging and something unique
that I haven't experienced before, I think is
what you said. They came up to this question
and they said, well, I'm sure this is what he
wants too on his because this is what I want
on mine. And he says, no, actually, I'd like
that different. And it is something that I had
encountered before, but never without the other
person knowing. This was the first time that
it got sprung on the spouse in the moment. Okay.
Which I appreciated so much. It made for an interesting
dynamic. It did. And the reason for sharing it
later, you know, not just, wow, I really had
an interesting work day. It opened a conversation
for us to have about, well, how would you, when
do you think that might change? When do you think
you might have a change of heart? And would you
tell me? Would you share with me ahead of time?
It's important for us to be on the same page.
Yeah, and I think I would have. I believe my
answer at the time was, You mean that's even
an option? Of course I want resuscitate. I want
every minute I can possibly have. Which prompted
the next question you asked me. Circumstances.
What if? Oh yeah, it was what if, well what if
your quality of life sucked at that point? Right.
And quality of life is... Well how bad was my
quality of life? I would have to have that...
I'm a person who has to have the terms defined.
And that's the key thing because quality of life
is so subjective. Your quality of life, come
to find out based on that conversation, your
quality of life is very different from my quality
of life. We have very different definitions of...
what we find acceptable. Well, one person might
be willing to let go while the other person,
you know, because they don't want to be a burden
on their family and their children. Another person
might want to say, no, I'm kind of greedy with
life. I want as much as I can get, even if I'm
bedridden, even if somebody has to feed me. I
don't know. And then halfway through that process,
you can still, because we're all dynamic individuals,
you can still have a change of heart and say,
you know, this feeding me thing, it really is
awful. And I can see the stress and the strain
and the burden it's putting on my family. Is
it too late to change my mind about that? And
it's never too late. As long as you're capable
of making that decision, then you can always
change your wishes. But the thing is, you have
to have that talk with the person that you have
chosen as your medical decision maker. And you
have to be confident that they're going to follow
through with what you have decided. Because let
me tell you something else that I have seen.
When I was working in the hospital, I have seen
multiple occasions. where we had advance directives
in writing, and we had families that didn't agree
with them. And let me tell you something. If
you have a doctor who is more concerned about
getting sued than they are about honoring your
wishes, guess what's going to happen? Yep. Oh,
my. There is a dynamic there that is very important
to consider. And those wishes are law, the advance
directives, even the simple five wishes. The
five wishes document is legally binding in 46
states. And I'm sure the other four states have
documents of their own that carry the same legal
binding. It is a legally binding document. However,
just like any other document, and I'm going to
pull out some wonderful examples here, just like
any other legally binding document, it is open
to interpretation. And you would think it would
be ironclad because it's so specific. Folks,
our Constitution's pretty specific too, but it's
interpreted 20 million different ways every day.
This is true, and while all of these are generally
upheld, as we all kind of know what they mean,
everyone has their own desire of what they'd
like it to mean. And that's what it comes down
to, the nuances. The nuances. The nuances. So
if you have... Person A who says they do not
want life support if they have no quality of
life. And that person needs life support. And
you have person B who is making their decisions.
And person B says, well... I would be okay if
I was bed -bound with a feeding tube and needed
a ventilator 24 -7 because to me the most important
thing is being alive. I don't care in what condition.
Therefore, to me, that's a decent quality of
life, so keep them alive. Not bothering to think
that person A, their definition of quality of
life might have been, if I can't take care of
myself, I don't want to be here. Those are, wow,
that's a heavy conversation and a hard thing
to decide, even for yourself. Because again,
as we were saying a minute ago, the dynamics
of it are your mind can change, your thoughts
can change as life events happen. And as medical
circumstances are experienced, it can make you
revisit these thoughts and change how you feel
about them. And perhaps even just... opening
that conversation with a loved one can alter
your perspective by putting yourself in their
shoes and realizing how your decision might affect
them and their lives. And there's so much that
goes into those decisions. There's not just the
emotional aspect. There's also the dynamics of
treatment that's involved. You know, if you have
someone who has cancer, for example, and they
don't want treatment, they don't want to do the
chemo, they don't want to do the radiation, they
don't want to do any of that, then the first
thing they're going to hear from people closest
to them, I would bet money because I've heard
it said, why are you giving up? Why are you giving
up? Yes. And cancer is not, that's a topic for
another show we're going to have to do. Yeah,
that's a whole show we can do about cancer. Because
cancer is not a battle to be won. It's not a
fight. And you hear that all the time. Oh, well,
you know, they lost their battle with cancer.
They lost their fight. You know, we need to donate
so they can keep fighting. Cancer is not a fight.
It is no different than any other diagnosis.
That can affect the body, requires treatment.
It's no different. But we have placed as a society
that mindset that it is to be defeated. We have
to defeat it. And unfortunately, the side effect
of that mindset, there's a stigma associated
with not treating it. Yeah. And it's a marketing.
I was sort of smiling because, not because the
topic isn't a serious one, but because as a communications
professional, I know that the whole concept of
the fight is a marketing tool. It's basically
a tool to raise funds for awareness, to raise
funds for defeating it. Because without that
sort of verbiage, People don't get riled up and
into the battle with you to help you fight something.
Well, you know, it's just like finding a cure.
That's a much milder form of saying, let's defeat
it, let's beat it, let's fight this battle. It's
the same as developing a cure for something.
But those sort of semantics don't get people
emotionally involved. Correct. So that's a marketing.
Now, to be clear. To be clear, I'm not saying
that people shouldn't donate because we need
that research. Absolutely. I learned the other
day, stepping off topic very briefly, but I learned
the other day that there are some types of cancers
now that five years ago were considered fatal
that they're now controlling with a daily medication.
You take a pill every day and congratulations,
your breast cancer is under control. That's right.
It's amazing. Isn't that a wonderful thing? And
that's the battle that's being won is the battle
to raise the funding, to do the research, and
to be able to find those solutions. The research
needs to happen. It's happening. We do need better
treatments and better early detection. I'm not
disputing that. I am 1 ,000 % behind that. Oh,
absolutely. What I am disputing is the emotional
baggage that is now. being associated with people
who have to factor in that treatment into their
definition of quality of life right right and
I want to, we have to bring this conversation
to a close because, again, we've run out of time.
It's good information. It's a good conversation
to have with your loved ones. It's a good conversation
to have with us, with your comments down below.
Please do weigh in with your thoughts and suggestions
for new topics. And before we go, because it's
such a doggy downer of a subject, I have to leave
you with a dad joke I heard today. Oh, no. A
1L llama. is a holy man in Tibet. A 2L llama
is a beast of burden. So what, I ask you, is
a 3L llama? I'm not even answering this. A 3L
llama is a really big fire in Boston. Of course,
this is all a highly personal choice and no conversations
we have on the Light Keepers podcast should ever
take the place of your own medical care team
or other professional advisor who should always
be consulted on the specific situational needs
that you have. We all need good information to
help make the most informed decisions and live
life on our own terms. This conversation is to
help you start thinking because most people are
not prepared at all. But some people are well
prepared indeed from joining us right here on
the Light Keepers podcast every Wednesday at
7 p .m. Eastern. The Light Keepers podcast is
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Speaking of that, hit that like and subscribe
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Clayton Vandiver, your Light Keeper. We'll see
you and your llama next time.