Motivated by their own personal experiences with loss, two long-time friends - Michael Bernhagen, a healthcare business development professional turned hospice advocate, and Terry Kaldhusdal, an award-winning public school teacher and filmmaker - decided to join forces in 2009 to produce a series of documentaries that has inspired thousands of conversations about end-of-life wishes.
Their first project, Consider the Conversation: A Documentary on a Taboo Subject, was partially funded by private donations including the donation of 3,500 hours of labor from the producers. It shared the perspectives of three terminally ill patients as well as the professionals who care for these kinds of people - doctors, nurses, social workers, clergy and several leading national experts. The film premiered in front of a sold out theatrical audience of 755 on 2/5/11, was released on DVD on 3/1/11 and its broadcast rights donated to public television stations via the National Educational Telecommunications Association (NETA) on 6/18/11. During its two and a half year PBS run, Consider the Conversation aired 611 times on 176 stations in 33 states and won 11 awards including journalistic excellence, viewer impact, and use of film for social change. 749 organizations also acquired educational use DVDs from the producers to host thousands of free community screenings around the United States and Canada like this one on the campus of Florida State University in Tallahassee.
More importantly, Consider the Conversation helped inspire the Wisconsin Medical Society to launch Honoring Choices Wisconsin, a statewide initiative seeking to make facilitated advance care planning conversations between medical professionals, patients and families a standard part of patient care in the Badger State. This outcome, chronicled in a 9/29/12 Milwaukee Journal Sentinel story entitled Wisconsin Men's End-of-Life Documentary Makes Waves, was historic because it marked the first time film was used to inspire sweeping systemic change within the expert culture of medicine.
Their second project, Consider the Conversation 2: Stories about Cure, Relief, and Comfort, was also partially funded by private donations including the producers' labor. It premiered on Wisconsin Public Television on 5/27/14, was nominated for a Regional Emmy® by the Chicago/Midwest Chapter of the National Academy of Television Arts & Sciences on 9/23/14, and released to public television stations nationwide via the National Educational Telecommunications Association (NETA) on 9/26/14. Consider the Conversation 2 takes a hard look at some of the unintended consequences of American medicine's success at fighting disease/extending life and sheds light on the important role of the patient/doctor relationship and patient/doctor communication when living with severe chronic disease. Broadcast 1,588 times on 268 PBS stations in 41 states, Consider the Conversation 2 won eleven awards, including two Bronze Tellys and the 2014 Global Film Awards Humanitarian Award. A total of 137 organizations also acquired educational use DVDs from the producers to host hundreds of free community screenings around the United States and Canada like this one at the Michigan Theater in Ann Arbor.
When Bernhagen and Kaldhusdal embarked upon this creative journey more than a decade ago, they envisioned a trilogy of Consider the Conversation films, each one designed to play a specific role in helping our culture move from ignorance to mastery as it pertains to knowing how to care well for the dying.
They were guided, in part, by a decades old theory from the field of psychology called the “conscious competence model”. This model postulates there are four stages to human learning and multiple ways of teaching that can help one move from unconscious incompetence (where a person doesn’t understand or know how to do something well and doesn’t necessarily recognize the knowledge deficit); to conscious incompetence (where, although the individual doesn’t understand or know how to do something well, he/she recognizes the deficit AND the value of acquiring a new skill to address that deficit); to conscious competence (where the person understands or knows how to do something well, but demonstrating that skill or knowledge involves a lot of hard work); to unconscious competence (where the individual has had so much practice with a particular skillset that it has become second nature and can be performed easily).
When looking at their work through this particular lens, the producers saw the potential Consider the Conversation: A Documentary on a Taboo Subject had to help all viewers develop a "thirst" for new and better ways to prepare loved ones and patients for end-of-life (i.e., build a bridge from unconscious incompetence to conscious incompetence); and the potential Consider the Conversation 2: Stories about Cure, Relief, and Comfort had to help role model for medical viewers the idea that communication is a skill that can be used with seriously ill patients for therapeutic benefit (i.e., build a bridge from conscious incompetence to conscious competence). Mike and Terry also saw a third and final Consider the Conversation film as one that could help all of us arrive at the elusive destination of “excellence” in end-of-life care.
Sadly, despite having a clear vision and demonstrable track record, the producers were unsuccessful in their attempts to find sustainable sources of revenue for Consider the Conversation and recently made the difficult, but practical, decision to end their collaboration on 12/31/21. On that date, Bernhagen and Kaldhusdal's groundbreaking digital work in the end-of-life genre will cease to be publicly available.
Meet the Filmmakers
THESE ARE SOCIAL ENTREPRENEURS IN ACTION
Terry Kaldhusdal (left), shown with his wife Janet, was Wisconsin's 2007 Teacher of the Year, the 2014 Fellow of the Lowell Milken Center for Unsung Heroes, and is an award-winning documentarian. His brother Pete's fight with pancreatic cancer brought Terry to focus on how we treat people who are seriously ill and his film work on end-of-life care has been called "narrative ethics at its best" by Myra Christopher, Founding Director of the Center for Practical Bioethics. During his 5-year (2009-2014) collaboration with Michael Bernhagen in this important genre, their work garnered 22 awards and an Emmy nomination.
Michael Bernhagen (right), with his wife Denise, is the Director of Community Engagement & Care Partner Relations at Rainbow Hospice Care in Jefferson, Wisconsin. Watching his mother Rita's slow decline from congestive heart failure and vascular dementia as well as the struggle of his family and her doctors when dealing with the process inspired Mike to leave curative medicine and join the hospice movement in 2004. Over time, Bernhagen's business development work has helped transform Jefferson County, Wisconsin into an "island of excellence" for end-of-life care. That is, it has become a place where more people receive hospice care at end-of-life than almost everywhere else in the United States (per Hospice Analytics, Jefferson County currently ranks 35th out of 3,143 counties nationally - Top 1.1%).
In 2017, Kaldhusdal and Bernhagen were nominated for a Humanities Award by the American Academy of Hospice and Palliative Medicine for their work on the Consider the Conversation film series. Amazingly, their film projects were never awarded a single grant by any foundation devoted to improving end-of-life care.
How were the first two Consider the Conversation films funded?
The first two installments in the Consider the Conversation film series were funded, in part, by private donations to a restricted fund established by the Rainbow Hospice Foundation, the fundraising arm of Rainbow Hospice Care, one of only six remaining independent and non-profit hospice programs operating in the state of Wisconsin.
Approximately $43,000 was raised by the producers for Consider the Conversation: A Documentary on a Taboo Subject and $44,000 for Consider the Conversation 2: Stories about Cure, Relief, and Comfort. These funds helped cover some, but not all, production expenses.
In order to complete these films, producers Michael Bernhagen and Terry Kaldhusdal donated 7,500 hours of their time - 3,500 for Consider the Conversation 1 and 4,000 for Consider the Conversation 2 - and spent some of their own money where necessary.
Unfortunately, none of the 23 grant applications they submitted to various foundations for additional funding related to production and distribution of the documentaries were accepted.
In September of 2013, Michael Bernhagen experienced a medical crisis because of the stress associated with this part of the production process. From that point forward, attempts by the producers to raise funds through grant applications ceased.