Embracing change series
taking charge and letting go
Story and photos by Richard Bermack
People are living longer, and at the same time they are less prepared for death. Death is frightening, and many people don’t want to think about it or discuss it. They are afraid of burdening others with their own fears and needs. A patient might say, “I can’t talk about dying with my kids.” And the kids say, “Don’t tell mom she’s in hospice, because we don’t want to upset her by letting her know she’s dying.”
Death is a natural and meaningful part of life. It needn’t be traumatic. But like any important event, perspective and planning are needed.
“Taking Charge and Letting Go,” the third presentation of the Embracing Change Series sponsored by the Member Support area at Ashby Village focused on end-of-life planning. It took place on September 12, 2017, at the Ashby Village office. Presenters included psychologist Kristina Holland, East Bay Conversation Project coordinator Leslie Deitterick, palliative care doctor Sally Sample, and death doula Lori Goldwyn. Topics included having conversations with family members and friends, clarifying what one wants, getting help in filling out advanced care directives, and the role of palliative care and doulas. The series was initiated by Hilda Hernández-Gravelle, lead staff for the Member Support Services Programs.
Communication is the first step. “Talk, talk, talk, talk,” advised therapist Kristina Holland. “Talk about your experience to yourself, your friends and family.”
The Conversation Project promotes understanding and engagement in advanced care planning so that a dying person’s health care treatment wishes are known and honored. It helps people talk about end-of-life issues and fill out advanced care directives. One issue is who will be in charge if you are incapacitated and can’t make medical decisions. It does not have to be a family member, explained Leslie Deitterick, the East Bay’s Conversation Project coordinator. It is important to review the documents regularly to be sure, for example, that the person identified to take charge is still alive.
Palliative care is about maintaining quality of life for those suffering from serious illness, including managing pain and coping with depression. Miracles of modern medicine have resulted in people living much longer, often with serious medical conditions and compromised physical abilities. Palliative caregivers like Dr. Sally Sample help patients and families understand the consequences of different health care treatments. For example, it is estimated that only 5 percent of seniors who are resuscitated after losing consciousness will return to their previous level of functionality.
This is where the form POLST (Physician Orders for Life-Sustaining Treatment) comes in. Among other things, this form indicates whether a person wishes to be resuscitated. “Fill out the POLST form and put it on your refrigerator,” Dr. Sample advises.
The end of life is about more than medical procedures. It is a time to make sense of one’s life and find meaning in it. Doulas deal with these spiritual and emotional issues. Many doulas were hospice volunteers who wanted additional training. “We step in as soon as the person goes into hospice. We can spend more time with them to help them explore the meaning of their life and help them put it into perspective,” doula Lori Goldwin explains. In today’s world, where family members may live in other states or be prevented by jobs and responsibilities from sitting for months at a dying person’s bedside, doulas are often hired to fill that role and take care of those needs.
For more information:
- Leslie Dietterick, ldietterick@accma.org, (510) 654-5383
- The East Bay Conversation Project, www.eastbayacp.org.
- Advanced directives: www.caringinfo.org, (800) 658-8898
- Palliative care: Dr. Sally Sample, www.hospiceeastbay.org/services/palliativecare, (925) 852-0010.
- Doulas: Lori Goldwyn, www.comingsandgoingsdoula.com, Lori KadishGoldwyn@gmail.com (415) 533-1153.
Over 50 people attended the program, including Ashby Village members and others from the community. The attendees welcomed the chance to talk about death and end-of-life issues. We asked several audience members what they got out of the program.
Bob Riksheim and Irene Bruemder
Bob – There is so much anecdotal information floating around that is just not correct. It is very refreshing hearing the real deal from experts in the field. We went through the death of a family member six months ago. The situation happened really quick and we weren’t prepared for it.
Irene – Now I understand the importance of filling out the healthcare directives and also want to learn more about palliative care and the role of doulas to provide guidance and help.
Sarah Puyans
I think Ashby Village is a great organization. It’s so enlightening to be part of a group that is seriously considering these questions and wants to understand the best way to manage our end-of-life situations. I’m a meditation teacher. Dealing with the issues of impermanence and death are part of my investigation about the meaning of life. Finding other people to discuss and share these realizations with is wonderful.
Winfred Wood
This was very helpful, talking about the psychology of having conversations of the experience of dying with your friends to create a supportive environment for everybody involved. I have a brother I would like to talk to about this workshop and I’m going to share my notes with him.
In my own life, I have a spinal cord injury, and it qualifies as a chronic illness. So one has to be patient and only take baby steps, so this is very helpful. This is a baby step.