Orange County Conversation Café

By Christine Chow, MSG
Orange County Aging Services Collaborative
Orange County POLST Coalition


If you work or volunteer in the world of palliative medicine and end-of-life care you know there can never be enough outreach and awareness when it comes to advance care planning. The question always remains: how can you take a topic surrounded by stigma (death and dying) and present it in a welcoming and friendly format?

The Orange County POLST Coalition has found a creative solution.

Last April the OC POLST Coalition celebrated National Healthcare Decisions Day by hosting a “Conversation Café,” bringing together more than 50 community members and professionals at Vivante on the Coast, a local assisted living facility in Costa Mesa, CA.

Orange County Conversation CaféThe Conversation Café concept came about in 2001 by two women in Seattle who wanted to create a “drop-in public dialogue format to serve democracy, critical thinking and neighborliness”, where people could gather and talk about things that really mattered. Conversation Cafés have since spread to more than 70 cities throughout the U.S., Canada and Europe.

In that Conversation Café spirit, the OC POLST Coalition partnered with the Orange County Aging Services Collaborative, St. Joseph Health Hospice, and Hoag CARES, and invited members of the community to have lunch, listen to a panel of expert speakers, and participate in small group discussions with facilitators on the importance of starting the conversation about end-of-life decisions. By the end of the day participants would have reviewed or completed an advance directive and become better informed about the use of POLST. The format of a Conversation Café helped participants determine how to initiate, or continue the conversation about, end-of-life care with their family members.

During the program, three physicians shared their perspectives on end of life issues:

  • “Care Issues: When the Patient is a Doctor,” Jack Cox, MD
  • “Family Dynamics: When the Doctor is a Son,” Subbarao Myla, MD
  • “The Intensity of the Intensivist’s View Point,” Bharne Abhinandan, MD

Orange County Conversation CaféPatty Mouton, from the Alzheimer’s Association Orange County, shared personal experiences on a family member who had a very peaceful death due to thoughtful planning, and a situation where the lack of communication before major surgery led to less than optimal care outcomes.

Lee-Anne Godfrey, RN, BSN, explained how to use the Advance Care Planning documents and discussed when POLST is an appropriate tool.

After the panel, facilitators worked with small groups to delve deeper into specific questions and help community members decide on next steps.

At the end of program, Dr. Vincent Nguyen, director of Hoag CARES, reemphasized the importance of initiating and continuing the dialogue of advance care planning with both loved ones and healthcare professionals.

The advance care planning Conversation Café left participants feeling better equipped for conversations with loved ones and healthcare providers about important healthcare decisions.

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