2. World Changing Access David Kessler

3. Are we a solution? The problem….

4. The Silver Tsunami

8. Where have we been?

9. Elisabeth Kübler Ross Photo by Ken Ross

11. A psychiatrist’s early lesson How do we reach them? What are they saying to us?

12. Those people at the end of the hall haven't changed- might be in the ICU now. They say, “No hospice.” “Hospice is not for me.” “I am not ready for hospice.”

13. The hospice way? or Your way? Do we meet people where they are?

15. Is that what we are offering? Tender loving care?

16. Picture the default death in the USA. Here is what we know

17. Active or Passive Decision?

18. What gets in the way of accessing this care? Most would choose this.

19. Healthcare was designed with diseases at its center, not people. The world we are changing is the world for the patient

20. Provider-Centered Care vs. Patient-Centered Care

21. Things are changing Hospital CEO – New Role “Home First” Discharge Planning

22. Loss is inevitable, suffering is optional.

23. We can’t stop dying, but we can improve how we die.

24. Unites the care-giver and care-receiver. End-of-Life Care…

25. You are excited, we can change the world! I can change, you can change! And this is what you hear… What about your peers?

26. “NO!” “It’s a tough call. We've never been good at this.” “We don’t want to look pushy.” “We can’t be too excited about hospice.”

27. “It’s too complicated.” “It’s always been like this.” “ It’s the same everywhere, no one has been able to move hospice access upstream ” “It’s not in the regulations or it’s not how hospice is done.” Jason Clarke

28. Different ways of saying change isn't going to happen. How do we take our passion and ideas and make them happen?

29. “It’s too complicated.” means Sounds to hard for me.

30. “It’s always been like this.” means The problem is older than you think.

31. “It’s the same everywhere, no one has been able to move hospice access upstream.” means The problem is broader than you think.

32. “It’s not in the regulations, it’s not how hospice is done.” means It hasn’t been updated.

33. When you realize what a difference you make, how do you inspire others? They have forgotten. Remind them. The death shapes the grief. Every time someone gets access to hospice it has a ripple effect. That access changes everything. Even housekeeping. Your peers don't feel like they make a difference

34. Environmental Services saving lives. Every doctor, every person on the hospice team can be the one that changes generations.

35. “I can’t wait to see how you deliver amazing care and change the world and make this more accessible.” You can keep things the same or you can make a difference, but you can’t do both.

36. No one will tell you… They don’t know how to articulate them. They have little experience with dying. Do they see death as a failure? The real reasons for not accessing care earlier

37. I am too full of emotions and fear to think. I'm scared of the transition, not the idea. I don’t know how big a deal this change really is. I feel like I have no say in what happens. Does this sound like somebody we talked about? The real reasons they don’t access us

38. Ronnie Kay

39. What happens – if and when acceptance occurs? Meaning? Sixth Stage?

40. I didn’t know this work was world changing I walk into your life in the worst moment and make it a little better. Imagine me at a party?

41. Addiction

42. Homelessness

43. How do you help 50,000 people?

44. Do what’s right for the patient and access will follow!