What it means to live a good life to the very end.

A health policy colleague suggested that I read Being Mortal by Atul Gwande MD. It wasn’t what I expected but I always enjoy Dr. Gwande’s books. His stories give us such good insight into some of the biggest challenges in healthcare. 

If you’re not familiar with Dr. Gwande, he is a surgeon, author and now the CEO of Haven Healthcare which is the organization charged with reinventing healthcare for Amazon, JP Morgan and Berkshire Hathaway employees.

Being Mortal is about well-being and what it means to live a good life right up to the very end.


Last year I stayed at my parents house while they were away. I discovered the HGTV channel and got hooked on all the home renovation shows. It doesn’t take long before you start contemplating a renovation.

I started imagining changes to my parent’s home that would make it more functional for them to continue living independently while making it easier for them to do all the things they love to do. Little did I know then that it is the lens we should all be using when considering our aging parents or loved ones nearing death. 

Happiness vs. Safety

Happiness is a big part of wellbeing but it often takes a backseat to safety especially in our final years. Most nursing homes and assisted living facilities operate on schedules and protocols to maximize operational efficiencies and profits. For many patients and residents, life becomes annoyingly routine, sterile and devoid of meaning. Nothing about the experience promotes happiness or wellbeing.

We all live with constraints and those constraints change with events, conditions and time. Fortunately, people’s ideas of what gives their life meaning and how they derive happiness evolves with age but the changes are unique to the person.

That’s why empowering people to live as independently as possible is so important to happiness and overall wellbeing. Many healthcare organizations realize that now too and are making efforts to incorporate home health programs. It’s the right direction and with the right expertise could make a big difference to their patients.


There are a lot of tough discussions to be had in order to help people live a good life to the very end. 

There are the obvious conversations that need to happen between healthcare professionals and patients about prognosis and options as well as within families about how loved ones want to experience the end of their life. The concept of well-being reframed the topic for me so that it felt more positive and easier to discuss. It might help reframe it for you too.

There is a broader discussion that also needs to be had about the lack of affordable housing.


There is a global housing problem with no clear solution yet. I attended a talk recently given by an urban planning professor and the author of the 5 Rules for Tomorrow’s Cities. It’s written about the global wealth gap and the lack of affordable housing in major cities.

Reportedly, increasing supply has not effectively addressed the issue. No matter how much supply ends on up on the market, it is bought by investors who are chasing a limited number of targets for their capital.

Four decades of flat wages and the 2008 financial crisis has had a profoundly negative impact on the middle class. The next wave of technology and automation will pose additional challenges. The economic table may be harder to tilt than some economists think.

According to the author, the only way to address the housing issue is to take public land [ie. golf courses] off the market and convert it into affordable housing within a self sustaining model. 

There is sure to be resistance to that idea. However, what is clear is that we need new ideas and approaches to solving the issue because it is increasingly clear that wages, housing and healthcare are closely linked.