Fostering engagement over the phone
After retirement, some people find it difficult to get out into the community and engage with other people. But, for 94-year-old Frances Utpadel, human connection has proven to be a phone call away.
In a service that is provided by the acting industry in Hollywood, the retired film lab technician from Los Angeles has availed herself of the Daily Call Sheet program. The program, run by the Motion Picture and Television Fund and the AARP Foundation, pairs up folks like Ms. Utpadel with a fellow film industry member for phone chats several times each week.
“I was having the downtime because all my friends were moving away and dying,” Ms. Utpadel explains in an interview with People magazine. Now, she and her chat-buddy Norma talk two or three times a week. Conversations range from things going on in their daily lives to world issues.
The content of the conversations can be stimulating, as is sharing her thoughts with a kind voice. “This is something I’m very much for – don’t isolate yourself. I don’t have any friends to be texting or emailing,” she says. “I hear so many people are doing texting and email, and one of the big stores now, they won’t have any cashiers. And, I say, ‘What are they doing to the people? You’re isolating people. And the world is made of people.’”
The connection is even more important for Ms. Utpadel, who for decades, has taken care of her son, Terry – who suffered debilitating injuries in a car crash. She is the sole caregiver for Terry, who is aged 75 years.
Ms. Utpadel is adamant about the value of human interaction in a digital world in which life can be lived in isolation. “I’m used to the generation where you took pictures and had them developed. You don’t have those now. Everybody’s got them on their cell phone. It’s just a whole different world. But, I think, in a way, my world is richer than the other one. I don’t feel deprived about it or anything. I feel I’m better off.”
Communication ‘central’ in palliative care
Being a palliative care surgeon means delivering really bad news. It also means helping a patients deal with the realities of impending death. In this emotionally charged atmosphere, the surgeons’ words can be comforting or devastating.
“One of my mentors once told me that words are somewhat like a palliative care physician’s scalpel,” Toronto palliative care physician Evan Schneider, MD, says in an interview with the Canadian Broadcasting Corporation.
“We’re dealing with very intense, emotionally charged conversations. I think communication is probably the most central tenet of what we do. … There’s no one-size-fits-all approach to sharing bad news,” said Dr. Schneider says. The bad news may be anticipated or can come as total blind-side to the patient. In some cases, other treatment options may be available. In other cases, palliative care is the only option.
Clarity in communication is an absolute must. That means providing the information in a form that is understandable and relevant to the patients, and not to the physician. Dr. Schneider says his approach involves “trying to use as little overly jargony or medicalized words as necessary.”
Compounding the challenge, Dr. Schneider’s patients exemplify the linguistic stew that is Toronto, where some 140 different languages are spoken. As an English speaker, Dr. Schneider relies on medical interpreters to talk with patients and for their sensitivity to cultural nuances concerning death and dying that escape him.
“Sometimes there are family members who may [want] to protect their loved one from receiving bad news about their diagnosis or prognosis,” he says. “When we bring an interpreter into those scenarios, it can be very hard for family members, because information can be shared through interpretation that were trying to shield their loved one. That’s always a risk or a possibility when we are dealing with information that has to be translated to someone else.”