ChaCha Chats

Dr. ChaCha Chats are private or group sessions with Dr. Charfen.

Dr. Charfen offers her expertise to patients and their loved ones that are navigating serious health issues, decisions or planning. You do not have to be her patient to participate as this is an educational consultation and not a medical consultation. The topics that can be explored are determined by you but may include:

• medical decision making
• talking with your doctor or specialists
• advance care planning
• community caregiving model of care
• end-of-life planning
• end-of life options: such as end-of-life doulas, hospice, VSED (voluntary stop eating and drinking, MAID (medical aid in dying).

Dr. Charfen’s consulting is individualized but can cover basic preparedness to much deeper, tender work, based on your needs and wishes.

This is not a medical consultation. Medical advice is not given by Dr. Charfen unless she has been retained as your physician although you are welcome to share any medical history during your sessions that will help you to develop your overall goals. 

Dr. Charfen’s consulting is open to anyone that has received a serious or terminal diagnosis, is dying or will die.

Yes, that means everyone!

Your fear, discomfort, and grief are all welcomed and cherished in a safe space and so is your humor.

Dr. Charfen works with patient’s and their loved ones in private or group settings to help facilitate understanding and communication around often uncomfortable or heavy discussions.

Consulting is offered throughout the world via a confidential internet channel or in-person on the island of Hawai’i. You can make a request on the secure portal.

The Basic Inquiry session is where most people will start. Private consulting for individuals is offered on a limited basis after a detailed questionnaire concerning you or your loved one’s current state of health and your present-day concerns are completed and submitted confidentially. After Dr. Charfen reviews your answers and concerns, an intake session will be scheduled for one hour. More sessions can be scheduled after the initial intake session if needed.

If you have found yourself in an acute state of confusion or fear due to a recent disturbing diagnosis or near death experience and simply need some clarification or a calming voice to help start your journey, this consulting is offered on an hourly basis strictly tailored to your immediate needs.

When you are being asked to make decisions that could prolong or end a dear one’s life, this can be devastating without support. If you find that you do not have the immediate support or information you need during these trying times, this type of consultation may benefit you.

Dr. Charfen realizes that emergencies don’t always happen during business hours or offer you the time to think deeply enough to complete questionnaires. She will do her best to accommodate your immediate needs.

This meaningful consulting is for anyone who has not done an advance healthcare directive and needs guidance or needs one reviewed. Many people already have some idea of what they want at the end of their life but have not taken the time to put this in writing and appoint a healthcare advocate. Each state has its own legal advance directive forms, which you can find here.

After reviewing your state’s advance directive, you may still have some questions about the medical implications of an advance directive that Dr. Charfen’s guidance can clarify, or just need a guide to walk you through addressing your own personal mortality. This consulting will only address your advance directive and health care advocate appointee during a one-hour session.  If you do the work required, you should be able to have a fully-executed advance directive after one or two sessions.

This consult is based on Dr. Charfen’s hourly consultation fee, unless you live in Hawai’i where this service can be billed to your insurance.

This is a completely personalized plan that you will create with Dr. Charfen that can cover as much or as little as you wish when it comes to your values and wishes concerning your own life & death. Examples include documenting end-of-life and emergency medical choices, life-sustaining  and palliative therapies, pain management and legacy work, to disposition of your body. This type of consulting goes into much more detail and requires a greater time commitment.

Some topics to explore could include:

• What are your wishes presently and as you near death, medically or otherwise?
• Have you thought about how you want to spend your last month, days, hours?
• Do you actually understand your advanced directive or do you even have one?
• Does the person who will be making decisions for you when you’re unable to do so understand your wishes? Is s/he willing to follow through on your behalf?
• Have you legally named this person as your healthcare advocate?
• Have you had the actual discussion with them?

Do you know that most advance healthcare directives do not address emergency care or the myriad of choices you or your loved ones will potentially be faced with when a medical emergency does arise?

Extremis is not the best time for most people to think logically about themselves or the ones they hold dear. We can not prepare for every situation that presents itself in our life. But unfortunately the overwhelming majority of people refuse to think of the end and therefore only vaguely prepare for it, even those with a terminal illness.

Why not create your own personal advanced plan? You will not avoid your inevitable death by denying or averting the subject. You will, however, make it much more difficult on everyone involved if they do not know or understand your wishes.

Doctors must assume you want everything done to extend your life unless you are specific. “Everything” does not always mean a great survival. In many cases, it can be prolonged torture. Most doctors are just as scared to talk about death as you are. Some see it as a failure in their skill as opposed to the natural thing that it is. And many loved ones will make decisions out of guilt as opposed to what is truly in your best interest based on your values or wishes.

An advanced plan does not guarantee that everything you request will happen, but it does increase the likelihood and gives loved ones a much more detailed roadmap of your values. In doing this detailed preparation, you are also giving your loved ones and yourself one of the most beautiful gifts Dr. Charfen has witnessed at the bedside of the dying. You are allowing for your end to be touched by love and peace, as opposed to fear and chaos.

This type of consultation is billed to you hourly unless you live in Hawai’i where your health insurance will cover this type of advance care planning.

Are you or a loved one actively dying from a terminal illness or facing that possibility in the near future?

This type of coaching is for the person or caregivers being faced with the enormity of imminent death. This can be a time of many different emotions such as fear, anger, denial, and, more importantly, love. This can actually be one of the most deeply intense and intimate moments of a person’s life. Dr. Charfen is honored to consult in these situations.