The obstacles to exercising our own choices at the end of our lives sometimes seem impossible to overcome. We are part of a culture that refuses to accept death, a medical system that reflects that culture and a lack of capable help in navigating an unfamiliar territory. When we add geographic impediments, once travel becomes difficult, a rural death can be particularly isolating. Micheal Fratkin, a doctor working in hospice and palliative care, felt compelled to do something about it. ResolutionCare, the organization he founded, integrates video conferencing and other innovative outlets to provide better care and more contact. He and his colleagues are able to act as an ongoing resource for their patients and families, available to guide and educate as the end of life approaches. This helps not only the patients but the entire system of family and friends around the patient. Could this innovative approach have implications for all end of life environments?

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