Beloved San Francisco Zen Hospice Project Confronts Its Own End
What Vets Want at the End of Life Is Very Different From What Civilians Want
Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home
Bay Area Cancer Patient Confronts and Embraces His Right to Die
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She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. 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She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_364223":{"type":"posts","id":"stateofhealth_364223","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"364223","score":null,"sort":[1534295909000]},"guestAuthors":[],"slug":"beloved-san-francisco-zen-hospice-project-confronts-its-own-end","title":"Beloved San Francisco Zen Hospice Project Confronts Its Own End","publishDate":1534295909,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>It was late May when the body of the last person to die in the guest house of the \u003ca href=\"https://www.zenhospice.org/\" target=\"_blank\" rel=\"noopener\">Zen Hospice Project\u003c/a> was carried down the stairs and through the back garden, then sprinkled with flower petals.\u003c/p>\n\u003cp>The San Francisco institution was founded during the height of the AIDS crisis, a time when sick men were left to die alone in the hallways of county hospitals because staff were afraid to touch them. Buddhist practitioners bought the Victorian on Page Street to create a place where men could get compassionate care and die with dignity.\u003c/p>\n\u003cp>Now, after 30 years of caring for people with all kinds of illnesses, the house is closing its doors. The organization no longer has enough money to keep the program going.\u003c/p>\n\u003cp>“It’s a little chaotic in here,” says George Kellar, the executive director of the last two and a half years, as we walk through the foyer of the house. “It’s in total transition.”\u003c/p>\n\u003cp>All the furniture is gone. The floors are covered with canvas tarps. Blue tape lines the perimeter of the living room. Men in jumpsuits and face masks are painting the fireplace, tearing up the carpet on the stairway and power washing the windows.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When the hospice issued its press release last week about this turn in the nonprofit’s fortunes, I noted the careful wording — that the guest house was “suspending” caregiving services, that they hoped they could “offer them again, at some point.” The implication was clear: Maybe a local tech billionaire could step in with a Hail Mary donation.\u003c/p>\n\u003cp>But this is a house that’s being primed for a realtor to stage it and put it up for sale.\u003c/p>\n\u003cp>“Five bedrooms, three bathrooms. It has a boarding house feel to it,” Kellar says as he gives me a tour of the upstairs. “It probably has that kind of history.”\u003c/p>\n\u003cp>Before the beds were cleared out, before all the nurses were laid off, the guest house had room for six residents. They called them “residents” not “patients.” This was their home, not a hospice. And they came here not to die, but to live fully until the end of their lives.\u003c/p>\n\u003cp>A corps of volunteers would sit with patients, sometimes for hours — just holding their hand, telling stories, singing songs. Kitchen staff prepared three meals a day to order for each resident, even when they could no longer eat.\u003c/p>\n\u003cp>“They can smell it, they can see it, if they want to taste that they can,\" Kellar says, adding that it's about letting the residents know \"they’re not discarded and ignored and not important.\"\u003c/p>\n\u003cp>The organization became a pioneer in what it means to die well. It helped shape a national movement away from sterile hospital deaths — hooked up to machines — to a mindful, aesthetic end that emphasized being present with what was happening.\u003c/p>\n\u003cp>Donors loved the mission and they were generous. Until the 2016 election.\u003c/p>\n\u003cp>“We’ve been struggling through 2017,” Kellar says.\u003c/p>\n\u003cp>This year, they’re more than $1 million short on their $2 million annual budget. Donors have been telling Kellar they have to cut back on their gifts to the hospice because they need to support issues that have come under attack during the Trump administration.\u003c/p>\n\u003cp>“Voting rights, or women in politics, or immigration help,” Kellar lists the other causes drawing donations instead of his organization. “And homeless, there’s a lot of interest in helping the homeless situation.”\u003c/p>\n\u003cfigure id=\"attachment_364227\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-364227\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/08/George-Kellar-looks-at-ZHP-art-book-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Kellar flips through a binder of art and embroidery pieces created by residents who died at the Zen Hospice Project's guest house. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nationally, philanthropy experts are waiting to see if this is a broader trend. The economy is strong right now and charitable giving has increased since the 2016 election, says Stacy Palmer, editor of the Chronicle of Philanthropy. But it’s unclear if people are giving more overall or shifting their dollars to issues that are in the news a lot.\u003c/p>\n\u003cp>“People really have to make choices about which charities they care about the most,” Palmer says, and in a time of shifting priorities, it can be harder to get people to open their wallets when it comes to end-of-life issues.\u003c/p>\n\u003cp>“People don’t really like to hear about death, even though what hospices do is really make death so much easier. It’s a tough conversation,” she says. “Sometimes really important causes are the ones that suffer just because they are dealing with difficult subjects.”\u003c/p>\n\u003cp>But some of the blame sits with the Zen Hospice Project itself. It relied too much on loyal donors, and didn’t cultivate enough new ones, Kellar says. And, for all these years, the hospice has declined to get licensed under the government’s Medicare and Medicaid programs, closing the door on a steady stream of reimbursement payments.\u003c/p>\n\u003cp>“We don’t want to compromise our commitment to this compassionate model,” Kellar explains. “And if that commitment is compromised by the reporting requirements or by the regulatory requirements, we don’t want to go there.”\u003c/p>\n\u003cp>But idealism doesn’t pay the bills. And that’s one of the reasons Kellar was brought in four years ago: to bring some business savvy to the nonprofit. He’s a Zen Buddhist, and he’s also a Silicon Valley guy — a software engineer with a background in sales and operations.\u003c/p>\n\u003cp>At first, he became right-hand man to the executive director at the time, BJ Miller, a doctor and a charismatic visionary who put the Zen Hospice Project in the national conscience through a high-profile New York Times \u003ca href=\"https://www.nytimes.com/2017/01/03/magazine/one-mans-quest-to-change-the-way-we-die.html\" target=\"_blank\" rel=\"noopener\">interview\u003c/a> and a \u003ca href=\"https://www.ted.com/talks/bj_miller_what_really_matters_at_the_end_of_life\">TED talk\u003c/a> that’s been viewed more than 7.5 million times. In it, Miller talks about the importance of “sensuous, aesthetic gratification” at the end of life and how the Zen Hospice Project wants to help people enjoy the last of their time by way of the five senses.\u003c/p>\n\u003cp>“Seriously, with all the heavy-duty stuff happening under our roof, one of the most tried and true interventions we know of is to bake cookies,” he said, the smell providing sustenance on so many levels. “As long as we have our senses — even just one — we have at least the possibility of accessing what makes us feel human, connected.”\u003c/p>\n\u003cfigure id=\"attachment_364225\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-364225\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/08/ZHP-Cookie-Book-close-up-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Zen Hospice Project's cookie recipe book sits with other nostalgic items moved out of the guest house as it is readied for sale. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kellar, on the other hand, talks about marketing and distribution and “scaling” operations.\u003c/p>\n\u003cp>“I am using businesslike terms to talk about it, but I think you have to,” he says.\u003c/p>\n\u003cp>When he took over the executive director position, the budget troubles were officially his responsibility.\u003c/p>\n\u003cp>One strategy he pursued was negotiating a partnership with some private insurance companies to have them reimburse for some of the hospice’s services. It’s an appealing value proposition for insurers: It costs $850 a day to care for each patient at the hospice, compared to the thousands and thousands of dollars in daily costs for someone to die in an ICU.\u003c/p>\n\u003cp>But after 18 months, there was still no agreement.\u003c/p>\n\u003cp>“We could no longer wait,” Kellar says.\u003c/p>\n\u003cp>Kellar presented the numbers to the board of directors, and they agreed they could no longer afford to keep the guest house going.\u003c/p>\n\u003cp>“As difficult and sad as it is, which it is, we’re letting it go,” Kellar says. “And that will create another space for something else to present itself. And maybe that something else is this massive opportunity.”\u003c/p>\n\u003cp>That could be an opportunity presented by the \u003ca href=\"https://www.caregiver.org/caregiver-statistics-demographics\" target=\"_blank\" rel=\"noopener\">43 million\u003c/a> informal caregivers in the U.S. — people taking care of their own ailing parents, spouses, or children — who need help. Kellar says if Zen Hospice Project sells the guest house, the organization can reinvest that money into its other programs: the volunteer program, which sends people to sit with the dying in the hospice floor of Laguna Honda Hospital, and the\u003ca href=\"https://www.zenhospice.org/education-training/mce/\" target=\"_blank\" rel=\"noopener\">Mindful Caregiver Education program\u003c/a>, which emphasizes caregivers taking care of themselves so they can take better care of others.\u003c/p>\n\u003cp>“Our mission is to transform the experience of dying and caregiving,” Kellar says. “And while we started at the bedside and continue at the bedside at Laguna Honda, it is now a time to focus on helping other people at the bedside by training and education.”\u003c/p>\n\u003cp>But selling this iconic San Francisco institution to as a private residence for 5 or 6 million dollars?\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“It’s not what I expected,” Kellar says, shifting from business guy to Zen guy. “I guess it’s a lesson in impermanence. And a lesson in ‘things change' and to not get as attached as we are because everybody here is very attached to this.”\u003c/p>\n\n","blocks":[],"excerpt":"Since the 2016 election, donors have been shifting their charitable dollars away from the hospice.","status":"publish","parent":0,"modified":1534296654,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1555},"headData":{"title":"Beloved San Francisco Zen Hospice Project Confronts Its Own End | KQED","description":"Since the 2016 election, donors have been shifting their charitable dollars away from the hospice.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Beloved San Francisco Zen Hospice Project Confronts Its Own End","datePublished":"2018-08-15T01:18:29.000Z","dateModified":"2018-08-15T01:30:54.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"364223 https://ww2.kqed.org/stateofhealth/?p=364223","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/08/14/beloved-san-francisco-zen-hospice-project-confronts-its-own-end/","disqusTitle":"Beloved San Francisco Zen Hospice Project Confronts Its Own End","audioTrackLength":366,"path":"/stateofhealth/364223/beloved-san-francisco-zen-hospice-project-confronts-its-own-end","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcrmag/2018/08/DemboskyZenHospiceProject.mp3","audioDuration":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It was late May when the body of the last person to die in the guest house of the \u003ca href=\"https://www.zenhospice.org/\" target=\"_blank\" rel=\"noopener\">Zen Hospice Project\u003c/a> was carried down the stairs and through the back garden, then sprinkled with flower petals.\u003c/p>\n\u003cp>The San Francisco institution was founded during the height of the AIDS crisis, a time when sick men were left to die alone in the hallways of county hospitals because staff were afraid to touch them. Buddhist practitioners bought the Victorian on Page Street to create a place where men could get compassionate care and die with dignity.\u003c/p>\n\u003cp>Now, after 30 years of caring for people with all kinds of illnesses, the house is closing its doors. The organization no longer has enough money to keep the program going.\u003c/p>\n\u003cp>“It’s a little chaotic in here,” says George Kellar, the executive director of the last two and a half years, as we walk through the foyer of the house. “It’s in total transition.”\u003c/p>\n\u003cp>All the furniture is gone. The floors are covered with canvas tarps. Blue tape lines the perimeter of the living room. Men in jumpsuits and face masks are painting the fireplace, tearing up the carpet on the stairway and power washing the windows.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When the hospice issued its press release last week about this turn in the nonprofit’s fortunes, I noted the careful wording — that the guest house was “suspending” caregiving services, that they hoped they could “offer them again, at some point.” The implication was clear: Maybe a local tech billionaire could step in with a Hail Mary donation.\u003c/p>\n\u003cp>But this is a house that’s being primed for a realtor to stage it and put it up for sale.\u003c/p>\n\u003cp>“Five bedrooms, three bathrooms. It has a boarding house feel to it,” Kellar says as he gives me a tour of the upstairs. “It probably has that kind of history.”\u003c/p>\n\u003cp>Before the beds were cleared out, before all the nurses were laid off, the guest house had room for six residents. They called them “residents” not “patients.” This was their home, not a hospice. And they came here not to die, but to live fully until the end of their lives.\u003c/p>\n\u003cp>A corps of volunteers would sit with patients, sometimes for hours — just holding their hand, telling stories, singing songs. Kitchen staff prepared three meals a day to order for each resident, even when they could no longer eat.\u003c/p>\n\u003cp>“They can smell it, they can see it, if they want to taste that they can,\" Kellar says, adding that it's about letting the residents know \"they’re not discarded and ignored and not important.\"\u003c/p>\n\u003cp>The organization became a pioneer in what it means to die well. It helped shape a national movement away from sterile hospital deaths — hooked up to machines — to a mindful, aesthetic end that emphasized being present with what was happening.\u003c/p>\n\u003cp>Donors loved the mission and they were generous. Until the 2016 election.\u003c/p>\n\u003cp>“We’ve been struggling through 2017,” Kellar says.\u003c/p>\n\u003cp>This year, they’re more than $1 million short on their $2 million annual budget. Donors have been telling Kellar they have to cut back on their gifts to the hospice because they need to support issues that have come under attack during the Trump administration.\u003c/p>\n\u003cp>“Voting rights, or women in politics, or immigration help,” Kellar lists the other causes drawing donations instead of his organization. “And homeless, there’s a lot of interest in helping the homeless situation.”\u003c/p>\n\u003cfigure id=\"attachment_364227\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-364227\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/08/George-Kellar-looks-at-ZHP-art-book-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Kellar flips through a binder of art and embroidery pieces created by residents who died at the Zen Hospice Project's guest house. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nationally, philanthropy experts are waiting to see if this is a broader trend. The economy is strong right now and charitable giving has increased since the 2016 election, says Stacy Palmer, editor of the Chronicle of Philanthropy. But it’s unclear if people are giving more overall or shifting their dollars to issues that are in the news a lot.\u003c/p>\n\u003cp>“People really have to make choices about which charities they care about the most,” Palmer says, and in a time of shifting priorities, it can be harder to get people to open their wallets when it comes to end-of-life issues.\u003c/p>\n\u003cp>“People don’t really like to hear about death, even though what hospices do is really make death so much easier. It’s a tough conversation,” she says. “Sometimes really important causes are the ones that suffer just because they are dealing with difficult subjects.”\u003c/p>\n\u003cp>But some of the blame sits with the Zen Hospice Project itself. It relied too much on loyal donors, and didn’t cultivate enough new ones, Kellar says. And, for all these years, the hospice has declined to get licensed under the government’s Medicare and Medicaid programs, closing the door on a steady stream of reimbursement payments.\u003c/p>\n\u003cp>“We don’t want to compromise our commitment to this compassionate model,” Kellar explains. “And if that commitment is compromised by the reporting requirements or by the regulatory requirements, we don’t want to go there.”\u003c/p>\n\u003cp>But idealism doesn’t pay the bills. And that’s one of the reasons Kellar was brought in four years ago: to bring some business savvy to the nonprofit. He’s a Zen Buddhist, and he’s also a Silicon Valley guy — a software engineer with a background in sales and operations.\u003c/p>\n\u003cp>At first, he became right-hand man to the executive director at the time, BJ Miller, a doctor and a charismatic visionary who put the Zen Hospice Project in the national conscience through a high-profile New York Times \u003ca href=\"https://www.nytimes.com/2017/01/03/magazine/one-mans-quest-to-change-the-way-we-die.html\" target=\"_blank\" rel=\"noopener\">interview\u003c/a> and a \u003ca href=\"https://www.ted.com/talks/bj_miller_what_really_matters_at_the_end_of_life\">TED talk\u003c/a> that’s been viewed more than 7.5 million times. In it, Miller talks about the importance of “sensuous, aesthetic gratification” at the end of life and how the Zen Hospice Project wants to help people enjoy the last of their time by way of the five senses.\u003c/p>\n\u003cp>“Seriously, with all the heavy-duty stuff happening under our roof, one of the most tried and true interventions we know of is to bake cookies,” he said, the smell providing sustenance on so many levels. “As long as we have our senses — even just one — we have at least the possibility of accessing what makes us feel human, connected.”\u003c/p>\n\u003cfigure id=\"attachment_364225\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-364225\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/08/ZHP-Cookie-Book-close-up-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Zen Hospice Project's cookie recipe book sits with other nostalgic items moved out of the guest house as it is readied for sale. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kellar, on the other hand, talks about marketing and distribution and “scaling” operations.\u003c/p>\n\u003cp>“I am using businesslike terms to talk about it, but I think you have to,” he says.\u003c/p>\n\u003cp>When he took over the executive director position, the budget troubles were officially his responsibility.\u003c/p>\n\u003cp>One strategy he pursued was negotiating a partnership with some private insurance companies to have them reimburse for some of the hospice’s services. It’s an appealing value proposition for insurers: It costs $850 a day to care for each patient at the hospice, compared to the thousands and thousands of dollars in daily costs for someone to die in an ICU.\u003c/p>\n\u003cp>But after 18 months, there was still no agreement.\u003c/p>\n\u003cp>“We could no longer wait,” Kellar says.\u003c/p>\n\u003cp>Kellar presented the numbers to the board of directors, and they agreed they could no longer afford to keep the guest house going.\u003c/p>\n\u003cp>“As difficult and sad as it is, which it is, we’re letting it go,” Kellar says. “And that will create another space for something else to present itself. And maybe that something else is this massive opportunity.”\u003c/p>\n\u003cp>That could be an opportunity presented by the \u003ca href=\"https://www.caregiver.org/caregiver-statistics-demographics\" target=\"_blank\" rel=\"noopener\">43 million\u003c/a> informal caregivers in the U.S. — people taking care of their own ailing parents, spouses, or children — who need help. Kellar says if Zen Hospice Project sells the guest house, the organization can reinvest that money into its other programs: the volunteer program, which sends people to sit with the dying in the hospice floor of Laguna Honda Hospital, and the\u003ca href=\"https://www.zenhospice.org/education-training/mce/\" target=\"_blank\" rel=\"noopener\">Mindful Caregiver Education program\u003c/a>, which emphasizes caregivers taking care of themselves so they can take better care of others.\u003c/p>\n\u003cp>“Our mission is to transform the experience of dying and caregiving,” Kellar says. “And while we started at the bedside and continue at the bedside at Laguna Honda, it is now a time to focus on helping other people at the bedside by training and education.”\u003c/p>\n\u003cp>But selling this iconic San Francisco institution to as a private residence for 5 or 6 million dollars?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s not what I expected,” Kellar says, shifting from business guy to Zen guy. “I guess it’s a lesson in impermanence. And a lesson in ‘things change' and to not get as attached as we are because everybody here is very attached to this.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/364223/beloved-san-francisco-zen-hospice-project-confronts-its-own-end","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_1"],"tags":["stateofhealth_3260","stateofhealth_3023","stateofhealth_2519","stateofhealth_3030","stateofhealth_3261"],"featImg":"stateofhealth_364226","label":"stateofhealth"},"stateofhealth_361907":{"type":"posts","id":"stateofhealth_361907","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361907","score":null,"sort":[1510218031000]},"guestAuthors":[],"slug":"what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","title":"What Vets Want at the End of Life Is Very Different From What Civilians Want","publishDate":1510218031,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n","blocks":[],"excerpt":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","status":"publish","parent":0,"modified":1510279371,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":817},"headData":{"title":"What Vets Want at the End of Life Is Very Different From What Civilians Want | KQED","description":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Vets Want at the End of Life Is Very Different From What Civilians Want","datePublished":"2017-11-09T09:00:31.000Z","dateModified":"2017-11-10T02:02:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361907 https://ww2.kqed.org/stateofhealth/?p=361907","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/11/09/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want/","disqusTitle":"What Vets Want at the End of Life Is Very Different From What Civilians Want","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2017/11/DemboskyVetsEndofLife.mp3","path":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","authors":["3205"],"categories":["stateofhealth_3012","stateofhealth_1"],"tags":["stateofhealth_2847","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_2656","stateofhealth_3194","stateofhealth_136","stateofhealth_3193"],"featImg":"stateofhealth_361951","label":"stateofhealth"},"stateofhealth_361724":{"type":"posts","id":"stateofhealth_361724","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361724","score":null,"sort":[1508953469000]},"guestAuthors":[],"slug":"hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home","title":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home","publishDate":1508953469,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Even when the fires threatened her home in downtown Sonoma, the elderly woman inside refused to leave. Smoke was everywhere. Her caretaker begged her to heed the mandatory evacuation order.\u003c/p>\n\u003cp>Another woman on the outskirts of town said all the young people telling her to get out were just “making hay” over nothing.\u003c/p>\n\u003cp>“They didn't want to leave because they wanted to die in their home,” said Karna Dawson, a social worker with \u003ca href=\"http://hospicebythebay.org/\" target=\"_blank\" rel=\"noopener\">Hospice by the Bay\u003c/a>. \"They didn't want to leave because they didn't realize the severity of the problem. They didn't want to leave because they were stubborn.”\u003c/p>\n\u003cp>At critical moments, when the worst wildfires in state history were ravaging Wine Country, Dawson and other members of the hospice team had to intervene in several such standoffs with terminally ill clients.\u003c/p>\n\u003cp>“Some people were feeling like if they were going to die they wanted to die in their house, and [were] not really thinking that through very clearly,” she said. “We're not talking about dying of your cancer. We're talking about dying in a fire. And those are two very different deaths.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When the fires broke out Oct. 8, nurses and staff with Hospice by the Bay were providing home care, pain management, and spiritual counseling to 108 patients in Napa and Sonoma counties. Half of those patients had to be evacuated.\u003c/p>\n\u003cp>Under federal rules, hospice agencies that receive payment from the Medicare program are required to have a disaster plan in place for their patients, including how to get bed-bound patients out of their homes.\u003c/p>\n\u003cp>Dawson was at work, enacting the plan, by 4 a.m. on Oct. 9, as the fires exploded across the area. She sat huddled over her laptop at home in Petaluma, wearing her grey pajamas and tattered pink bathrobe. She was talking on two phones at once, trying to find all their patients and ordering ambulances. In some cases, once the ambulances picked up the patients, they just drove away from the fires, to get to safety. The hospice staff had to figure out where exactly they had gone .\u003c/p>\n\u003cp>“It was just a moving target of where people were going and where they were landing,” said Wendy Ranzau, the hospice’s chief operating officer.\u003c/p>\n\u003cp>For many patients, the first stop was a Red Cross evacuation shelter. This required hospice leaders to adjust their goals, while still trying to fulfill the mission of providing patients an opportunity to die with dignity.\u003c/p>\n\u003cp>“Our priority was to make sure that we did not have a patient die in an evacuation center,” Ranzau said. “So even if they can’t die at home, they’re going to die someplace other than a cot in an auditorium.”\u003c/p>\n\u003cfigure id=\"attachment_361727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Karna-Dawson-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Karna Dawson helped lead the effort to make sure patients getting care from Hospice by the Bay were safely evacuated during the North Bay wildfires. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Within two days, the hospice had safely relocated all of the patients, even ones who had temporarily ended up in shelters. Some patients went to live with relatives all over the state, from Citrus Heights in the north, to Santa Barbara down south. Some were resettled in assisted living or skilled nursing facilities, with Hospice by the Bay dipping into its reserves to pay the fees, something the Medicare program does not require.\u003c/p>\n\u003cp>But there were a couple of hold-outs who found the shelters surprisingly hospitable.\u003c/p>\n\u003cp>“There was one gentleman who didn't want to leave the shelter. He had lived alone and he was loving the attention. He thought it was great,” Dawson said. “It took us 24 hours and the medics saying 'You can't really stay here.'”\u003c/p>\n\u003cp>Many patients were eventually able to return to their homes. But Ranzau predicts some never will. Either their homes burned down, or there’s no power, or because the are too medically fragile tosurvive another move. One patient lost five pounds in the week after the fire started.\u003c/p>\n\u003cp>“When you think about hospice, our median length of stay is about three weeks,” Ranzau said. “A week in the life of a hospice patient, unfortunately, is a third of their time on hospice. So it just doesn't make sense. You know, is a trauma of transferring again, too much for them?”\u003c/p>\n\u003cp>That means some patients will not have the death they planned, making them a tragic piece of the overall hospice trend: 70 percent of Californians say they want to die at home, but only 32 percent do. Now the Sonoma woman with cancer, whose dying wish was to spend her final days in her own house, will die in a nursing home.\u003c/p>\n\u003cp>“She’s okay. She’s okay,” Dawson said uncertainly, when asked about her status a week after the fires began. “She’s adjusting.”\u003c/p>\n\u003cp>For most of their patients, there just isn’t enough time to adapt to all the changes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I, or you, can have six months or a year to process this and think it through,” she said. “We can have another fall that's pretty and recover. Where they might not, and likely won’t.”\u003c/p>\n\n","blocks":[],"excerpt":"The fires took away the last wish of scores of terminally ill people: to die peacefully, in their own beds. ","status":"publish","parent":0,"modified":1509068338,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":901},"headData":{"title":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home | KQED","description":"The fires took away the last wish of scores of terminally ill people: to die peacefully, in their own beds. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home","datePublished":"2017-10-25T17:44:29.000Z","dateModified":"2017-10-27T01:38:58.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361724 https://ww2.kqed.org/stateofhealth/?p=361724","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/10/25/hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home/","disqusTitle":"Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2017/10/HospiceFireDembosky.mp3","path":"/stateofhealth/361724/hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Even when the fires threatened her home in downtown Sonoma, the elderly woman inside refused to leave. Smoke was everywhere. Her caretaker begged her to heed the mandatory evacuation order.\u003c/p>\n\u003cp>Another woman on the outskirts of town said all the young people telling her to get out were just “making hay” over nothing.\u003c/p>\n\u003cp>“They didn't want to leave because they wanted to die in their home,” said Karna Dawson, a social worker with \u003ca href=\"http://hospicebythebay.org/\" target=\"_blank\" rel=\"noopener\">Hospice by the Bay\u003c/a>. \"They didn't want to leave because they didn't realize the severity of the problem. They didn't want to leave because they were stubborn.”\u003c/p>\n\u003cp>At critical moments, when the worst wildfires in state history were ravaging Wine Country, Dawson and other members of the hospice team had to intervene in several such standoffs with terminally ill clients.\u003c/p>\n\u003cp>“Some people were feeling like if they were going to die they wanted to die in their house, and [were] not really thinking that through very clearly,” she said. “We're not talking about dying of your cancer. We're talking about dying in a fire. And those are two very different deaths.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When the fires broke out Oct. 8, nurses and staff with Hospice by the Bay were providing home care, pain management, and spiritual counseling to 108 patients in Napa and Sonoma counties. Half of those patients had to be evacuated.\u003c/p>\n\u003cp>Under federal rules, hospice agencies that receive payment from the Medicare program are required to have a disaster plan in place for their patients, including how to get bed-bound patients out of their homes.\u003c/p>\n\u003cp>Dawson was at work, enacting the plan, by 4 a.m. on Oct. 9, as the fires exploded across the area. She sat huddled over her laptop at home in Petaluma, wearing her grey pajamas and tattered pink bathrobe. She was talking on two phones at once, trying to find all their patients and ordering ambulances. In some cases, once the ambulances picked up the patients, they just drove away from the fires, to get to safety. The hospice staff had to figure out where exactly they had gone .\u003c/p>\n\u003cp>“It was just a moving target of where people were going and where they were landing,” said Wendy Ranzau, the hospice’s chief operating officer.\u003c/p>\n\u003cp>For many patients, the first stop was a Red Cross evacuation shelter. This required hospice leaders to adjust their goals, while still trying to fulfill the mission of providing patients an opportunity to die with dignity.\u003c/p>\n\u003cp>“Our priority was to make sure that we did not have a patient die in an evacuation center,” Ranzau said. “So even if they can’t die at home, they’re going to die someplace other than a cot in an auditorium.”\u003c/p>\n\u003cfigure id=\"attachment_361727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Karna-Dawson-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Karna Dawson helped lead the effort to make sure patients getting care from Hospice by the Bay were safely evacuated during the North Bay wildfires. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Within two days, the hospice had safely relocated all of the patients, even ones who had temporarily ended up in shelters. Some patients went to live with relatives all over the state, from Citrus Heights in the north, to Santa Barbara down south. Some were resettled in assisted living or skilled nursing facilities, with Hospice by the Bay dipping into its reserves to pay the fees, something the Medicare program does not require.\u003c/p>\n\u003cp>But there were a couple of hold-outs who found the shelters surprisingly hospitable.\u003c/p>\n\u003cp>“There was one gentleman who didn't want to leave the shelter. He had lived alone and he was loving the attention. He thought it was great,” Dawson said. “It took us 24 hours and the medics saying 'You can't really stay here.'”\u003c/p>\n\u003cp>Many patients were eventually able to return to their homes. But Ranzau predicts some never will. Either their homes burned down, or there’s no power, or because the are too medically fragile tosurvive another move. One patient lost five pounds in the week after the fire started.\u003c/p>\n\u003cp>“When you think about hospice, our median length of stay is about three weeks,” Ranzau said. “A week in the life of a hospice patient, unfortunately, is a third of their time on hospice. So it just doesn't make sense. You know, is a trauma of transferring again, too much for them?”\u003c/p>\n\u003cp>That means some patients will not have the death they planned, making them a tragic piece of the overall hospice trend: 70 percent of Californians say they want to die at home, but only 32 percent do. Now the Sonoma woman with cancer, whose dying wish was to spend her final days in her own house, will die in a nursing home.\u003c/p>\n\u003cp>“She’s okay. She’s okay,” Dawson said uncertainly, when asked about her status a week after the fires began. “She’s adjusting.”\u003c/p>\n\u003cp>For most of their patients, there just isn’t enough time to adapt to all the changes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I, or you, can have six months or a year to process this and think it through,” she said. “We can have another fall that's pretty and recover. Where they might not, and likely won’t.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361724/hospice-scrambled-during-california-wildfires-to-evacuate-patients-determined-to-die-at-home","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_12","stateofhealth_3012"],"tags":["stateofhealth_3184","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_3183"],"featImg":"stateofhealth_361764","label":"stateofhealth"},"stateofhealth_281518":{"type":"posts","id":"stateofhealth_281518","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"281518","score":null,"sort":[1483743098000]},"guestAuthors":[],"slug":"bay-area-man-confronts-and-embraces-his-right-to-die","title":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","publishDate":1483743098,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cem>Last year, California became the fifth state to allow terminally ill patients to take lethal medication to end their lives. The new law -- the \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/03/10/californias-physician-assisted-suicide-law-to-take-effect-in-june/\" target=\"_blank\">End of Life Option Act\u003c/a> -- took effect in June, 2016.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Piedmont resident \u003cstrong>Ray Perman\u003c/strong> always knew this is the way he wanted to go. He’s 64, a retired pilot, like his father, and an entrepreneur. He’s dying of cancer. I interviewed him about his decision. The following words, culled from that interview, are his.\u003c/em>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/301315866\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>My pelvis is fully populated by prostate cancer. I have a one-inch tumor in my tailbone. I have seven tumors in my ribs, like little Christmas tree lights. So about two months ago, my physician called me in and said, 'Well Ray, we've done everything we can.' I said, 'Well then I want to be on hospice. And I'd like to have you start with End of Life Options.' He looked at me and said 'I'll write the prescription.'\u003c/p>\n\u003cp>So now I have my medical aid-in-dying drugs up in my bedroom, ready to go. You're not allowed to go to the pharmacy and go pick them up. They won’t have you inadvertently leave them on the seat of the 57 bus. It has to be delivered like a loaded weapon. So the end-of-life options team came here with three people, the pharmacist with the drugs, my case manager and also another witness. They arrived here with these drugs and they went through the instructions on how to use them, and had me sign all the appropriate documents under witness, which is what they should absolutely do.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Remember that I have to take these prescriptions on my own. No one can assist me. No one can cajole or put the straw in my mouth or squeeze the drugs into my mouth. I have to take them, which means I have to have the ability to swallow. So what the hospice team is learning, they give you about a five-day window when you can do this drug and do the deed. And they’re learning, because they’ve missed a couple of times with other patients. They didn't call it early enough, and the person could no longer do the drug and they feel very badly.\u003c/p>\n\u003cfigure id=\"attachment_281642\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281642\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayPermanPercussion-800x1002.jpg\" alt=\"Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands.\" width=\"800\" height=\"1002\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-768x962.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-240x301.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-375x470.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-520x651.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>They’ve giving me markers, clues as you get closer to the end. You look for changes in perception of food taste, general weakness, or the need to take a mid-morning nap, which I'm starting to do now. My stairway is a measuring device. People say, ‘Ray, should you get a hospital bed down here?’ I say, no I don't want to die in my living room. I have a beautiful bedroom with windows on three sides, I want to look at my view. So if I can't get up the stairway anymore, it means we’re darn close. And we are kind of close.\u003c/p>\n\u003cp>It will be a hard decision. People who go for the aid-in-dying option, I understand only 65 percent actually do it. Of the people who don't, some basically die of symptoms prior to using the option, some simply change their mind. You know, I'm not a hero. I may chicken out.\u003c/p>\n\u003cp>I attended my daughter's wedding in September and afterwards my oncologist said, the whole department, we figured you had 50/50 odds of attending. And I had a 70 percent chance of dying last month in December. I mean, who knows how it'll go. Some days I wake up and I can feel cancer coming. It feels like I'm not going to make it to January 15. I have meetings on January 15 -- I’ve got to make those meetings. And my wonderful in-home care provider, she’s pregnant and she's going to give birth around February 15.\u003c/p>\n\u003cp>Our goal is for me to hold the baby. It'll be great. Maybe I’ll get there.\u003c/p>\n\u003cfigure id=\"attachment_281644\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281644\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayFlying-800x778.jpg\" alt=\"Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27.\" width=\"800\" height=\"778\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-160x156.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-768x747.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-240x233.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-375x365.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-520x506.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-50x50.jpg 50w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I made sure that the newspapers don't say 'Ray lost his battle with cancer.' There’s no battle. If I were to be battling or struggling I would be preempting my ability to soak in all the wonderful things that are happening to me emotionally.\u003c/p>\n\u003cp>For me the epiphany in all of this is that I shifted from wanting to die quickly to wanting to enjoy this last phase. I think it's the explorer in me. I want to carry the torch into that last phase and say 'My gosh, look what I'm discovering. It's beautiful.' You shouldn't miss it. Don't fear death. It's wrong.\u003c/p>\n\u003cfigure id=\"attachment_281521\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281521\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/KP-Racing-Team-2016-05-1-800x450.jpg\" alt=\"Ray Perman says he's maintained his "rollicking" sense of humor after being diagnosed with two types of cancer.\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman says he's maintained his \"rollicking\" sense of humor after being diagnosed with two types of cancer. \u003ccite>(Courtesy of Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When the hospice team gives me the five day window, I will announce to my relatives: It's time. I'm going to make it this day, come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I will have my closest loved ones around me when I do that. I'll have an open house in the morning for my friends to give me a hug goodbye and then we'll probably do the deed in the afternoon. Then my family can have time with my body in the evening, as long as they’d like. And I have a complete description on where to dispose of my ashes. It'll be in the departure path of a Boeing aircraft that took off with my father, on an outgoing tide.\u003c/p>\n\n","blocks":[],"excerpt":"Piedmont resident Ray Perman tells the story of how he's approaching his last phase of life.","status":"publish","parent":0,"modified":1483754678,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":1049},"headData":{"title":"Bay Area Cancer Patient Confronts and Embraces His Right to Die | KQED","description":"Piedmont resident Ray Perman tells the story of how he's approaching his last phase of life.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","datePublished":"2017-01-06T22:51:38.000Z","dateModified":"2017-01-07T02:04:38.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"281518 http://ww2.kqed.org/stateofhealth/?p=281518","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/01/06/bay-area-man-confronts-and-embraces-his-right-to-die/","disqusTitle":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","path":"/stateofhealth/281518/bay-area-man-confronts-and-embraces-his-right-to-die","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Last year, California became the fifth state to allow terminally ill patients to take lethal medication to end their lives. The new law -- the \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/03/10/californias-physician-assisted-suicide-law-to-take-effect-in-june/\" target=\"_blank\">End of Life Option Act\u003c/a> -- took effect in June, 2016.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Piedmont resident \u003cstrong>Ray Perman\u003c/strong> always knew this is the way he wanted to go. He’s 64, a retired pilot, like his father, and an entrepreneur. He’s dying of cancer. I interviewed him about his decision. The following words, culled from that interview, are his.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/301315866&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/301315866'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>My pelvis is fully populated by prostate cancer. I have a one-inch tumor in my tailbone. I have seven tumors in my ribs, like little Christmas tree lights. So about two months ago, my physician called me in and said, 'Well Ray, we've done everything we can.' I said, 'Well then I want to be on hospice. And I'd like to have you start with End of Life Options.' He looked at me and said 'I'll write the prescription.'\u003c/p>\n\u003cp>So now I have my medical aid-in-dying drugs up in my bedroom, ready to go. You're not allowed to go to the pharmacy and go pick them up. They won’t have you inadvertently leave them on the seat of the 57 bus. It has to be delivered like a loaded weapon. So the end-of-life options team came here with three people, the pharmacist with the drugs, my case manager and also another witness. They arrived here with these drugs and they went through the instructions on how to use them, and had me sign all the appropriate documents under witness, which is what they should absolutely do.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Remember that I have to take these prescriptions on my own. No one can assist me. No one can cajole or put the straw in my mouth or squeeze the drugs into my mouth. I have to take them, which means I have to have the ability to swallow. So what the hospice team is learning, they give you about a five-day window when you can do this drug and do the deed. And they’re learning, because they’ve missed a couple of times with other patients. They didn't call it early enough, and the person could no longer do the drug and they feel very badly.\u003c/p>\n\u003cfigure id=\"attachment_281642\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281642\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayPermanPercussion-800x1002.jpg\" alt=\"Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands.\" width=\"800\" height=\"1002\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-768x962.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-240x301.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-375x470.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-520x651.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>They’ve giving me markers, clues as you get closer to the end. You look for changes in perception of food taste, general weakness, or the need to take a mid-morning nap, which I'm starting to do now. My stairway is a measuring device. People say, ‘Ray, should you get a hospital bed down here?’ I say, no I don't want to die in my living room. I have a beautiful bedroom with windows on three sides, I want to look at my view. So if I can't get up the stairway anymore, it means we’re darn close. And we are kind of close.\u003c/p>\n\u003cp>It will be a hard decision. People who go for the aid-in-dying option, I understand only 65 percent actually do it. Of the people who don't, some basically die of symptoms prior to using the option, some simply change their mind. You know, I'm not a hero. I may chicken out.\u003c/p>\n\u003cp>I attended my daughter's wedding in September and afterwards my oncologist said, the whole department, we figured you had 50/50 odds of attending. And I had a 70 percent chance of dying last month in December. I mean, who knows how it'll go. Some days I wake up and I can feel cancer coming. It feels like I'm not going to make it to January 15. I have meetings on January 15 -- I’ve got to make those meetings. And my wonderful in-home care provider, she’s pregnant and she's going to give birth around February 15.\u003c/p>\n\u003cp>Our goal is for me to hold the baby. It'll be great. Maybe I’ll get there.\u003c/p>\n\u003cfigure id=\"attachment_281644\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281644\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayFlying-800x778.jpg\" alt=\"Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27.\" width=\"800\" height=\"778\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-160x156.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-768x747.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-240x233.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-375x365.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-520x506.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-50x50.jpg 50w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I made sure that the newspapers don't say 'Ray lost his battle with cancer.' There’s no battle. If I were to be battling or struggling I would be preempting my ability to soak in all the wonderful things that are happening to me emotionally.\u003c/p>\n\u003cp>For me the epiphany in all of this is that I shifted from wanting to die quickly to wanting to enjoy this last phase. I think it's the explorer in me. I want to carry the torch into that last phase and say 'My gosh, look what I'm discovering. It's beautiful.' You shouldn't miss it. Don't fear death. It's wrong.\u003c/p>\n\u003cfigure id=\"attachment_281521\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281521\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/KP-Racing-Team-2016-05-1-800x450.jpg\" alt=\"Ray Perman says he's maintained his "rollicking" sense of humor after being diagnosed with two types of cancer.\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman says he's maintained his \"rollicking\" sense of humor after being diagnosed with two types of cancer. \u003ccite>(Courtesy of Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When the hospice team gives me the five day window, I will announce to my relatives: It's time. I'm going to make it this day, come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I will have my closest loved ones around me when I do that. I'll have an open house in the morning for my friends to give me a hug goodbye and then we'll probably do the deed in the afternoon. Then my family can have time with my body in the evening, as long as they’d like. And I have a complete description on where to dispose of my ashes. It'll be in the departure path of a Boeing aircraft that took off with my father, on an outgoing tide.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/281518/bay-area-man-confronts-and-embraces-his-right-to-die","authors":["3205"],"categories":["stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_914","stateofhealth_3024","stateofhealth_2847","stateofhealth_3022","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_281571","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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