The Conversation

“What are your goals and values of how you want to live your life?” 


of people want to die at home.


actually do.


of people spend their last days in an ICU.


of people are dying in pain.

Brenda S. Ho, CEO
Hawai‘i Care Choices
You Have Choices

David Kessler, the author of, ‘Needs of the Dying,’ reminds us that, “Americans treat death as optional.” Even though each of us would like to think death “will never happen to me, or those I love,” we all know that someday it will. 


Great conversations are being initiated locally through groups like Community First, and nationally by doctors such as Atul Gawande, cancer surgeon and author of ‘Being Mortal,’ discussing how we, as a society, can better deal with the frailties of an aging population.


Medical advances have made it possible to live with a serious illness for many years.  For this reason, Gawande encourages these four questions be discussed between physician and patient:

  • What is the patient’s understanding of his or her condition?

  • What are the patient’s goals if health worsens?

  • What are the patient’s fears?

  • And what trade-offs are the patient willing and not willing to make?

When given a serious or life-limiting diagnosis, like heart disease, cancer, or Alzheimer’s, denial of mortality leaves remaining time to chance; missing out on what could make a difficult situation better. 

You have care choices.  Those choices are best based on your values.  What is important to you – time with grandkids, taking that long-planned for trip, having your favorite wine, tending to your garden?  The care you receive should be the care you want.  Have the conversation.  

“In our complex healthcare system, by default you will receive aggressive, invasive care, no matter how old you are, no matter how sick you are, even if it won’t help you, unless you opt out – loudly.  Ending Well is a human issue, not a medical one.”


Dr. Shoshana Ungerleider, Founder, End Well & Ungerleider Fund

Watch as one family has 'The Conversation' 

Starter Kit - The Conversation Project

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If you or a loved one is dealing with a chronic debilitating illness or is facing a life-limiting disease, a combination of a POLST and an Advance Health Care Directive gives the best opportunity to have wishes followed in the event a person cannot speak for himself or herself.

Register for the free Advance Health Care Directive information sessions at the Aging and Disability Resource Center in Hilo.

If you would like to speak to Community First, please call:

Amy Hamane  (808) 935 - 1500

Tony Kent         (808) 464 - 2800