End of Life Choices California—Here for You

Watching things bloom this time of year makes me think a lot about End of Life Choices California and how we too are growing. 

I am pleased and honored to share that I am no longer the “acting volunteer executive director” which I have been since our humble beginnings, as the Board of Directors recently voted to appoint me as our official Executive Director.

When the other founding directors and I started EOLCCA back in the spring of 2019, our vision was to help people access a peaceful death. Big vision! We were driven by the daunting realization of how few people, doctors, and hospices knew about California’s at the time newer End of Life Option Act legalizing medical aid in dying (MAiD), as well as all the other end-of-life options.

On our YouTube channel

As part of our ongoing effort to educate the public and health care providers about the law, we have created a short video designed to reach a broad audience. I am delighted to share it with you here.

Please take 3 minutes to learn about the positive impact we have on peoples’ lives.

I invite you to share it with your own networks so more people can be aware of this law and how to reach us.

To educate and empower

We continue the work we started back in 2019 with high hopes and dreams of continued growth and the ability to reach, educate and empower Californians so they know what all their end-of-life options are, and how to access them. One of our greatest satisfactions has been the specialized presentations we have provided to hospices. We have had the privilege of providing education to dozens of hospices throughout the state – from their MDs, RNs and MSWs to their bereavement counselors and volunteers.

To schedule a presentation, please contact our Speaker’s Bureau coordinator at speaker@endoflifechoicesca.org

Dedication

Day to day, on the ground, our dedicated cadre of Client Volunteers provide the backbone of our operation. In 2023 alone, we have already fielded calls and emails from nearly 500 people. Our amazing volunteers offer support and guidance to empower individuals to navigate the medical system and effectively communicate their end-of-life wishes. We have built a rich resource center over the years so they can provide information about physicians willing to prescribe MAiD, supportive hospices with physicians who prescribe MAiD, and other pertinent support services in their community. In addition, our volunteers are skillfully trained and honored to be present bedside to support the family or loved ones on the day the client chooses to take medical aid in dying.  

“During a period of time when we were in desperate need of guidance and information and a resolution, we came across the organization (EOLCCA) and it helped us every step of the way.”

— Matt Mayerson, family member

Matt Mayerson

Sharing and giving

We are so grateful to the many supporters of EOLCCA who are helping us reach a larger audience by sharing our video widely. For more information about how you can support our mission through a tax-deductible gift, please visit our donation page.  Every donation, large and small, is deeply appreciated and helps us reach more people to ensure they are able to access the end-of-life care and dying that they want.

In the words of Henry David Thoreau, “…one must maintain a little bit of summer, even in the middle of winter.”  We feel the work we do provides just that: brings the lightness of summer to an often-wintry time for those facing the end of their lives. 

Best wishes for a lovely summer.

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EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help.  Thank you for your support!

What actually happens during a MAID death.

As an End of Life Choices California (EOLCCA) bedside client volunteer and retired medical professional, I’ve attended both medically-assisted deaths (MAID) and non-MAID deaths. Most people who qualify choose MAID because they want some control over how and when they die once they are declared terminally ill. Their diseases have already taken so much control away from them.

Sometimes people never even take the MAID prescription but feel comforted by knowing they have it in case of need. Other times the disease progresses too quickly, and they lose the capacity to ingest the medication themselves as the law requires.  We advise people not to wait until the last moment to start the process of making their requests for MAID from two doctors. It can take a while to find a prescribing doctor if your physician won’t prescribe (or participate in MAID). Once prescribed, the medication must be prepared by a special compounding pharmacy and it could take up to a week to be prepared and delivered.

Our client volunteers are trained to work with people and their loved ones prior to ingestion to prepare them for the process, so they feel safe in deciding to just have family/friends present if that is their wish.  However, if needed, we are honored to be there the day they take their medication.

peaceful river scene
Questions

We answer many questions in the period leading up to the day of death and on that day itself.
As questions arise, we answer them all. 
Typical questions include:

  • What if the medications don’t work?
    Answer: The MAID medications prescribed by the doctor are lethal and are intended to be fully effective. With the client and their family, we thoroughly review the medications and procedures, and confirm that the client still wishes to take them on the day of death. 
  • How long will it take to die?
    Answer: Within five to ten minutes after ingestion, the patient will fall into a deep sleep and then into a coma and be unaware of anything else. It will take between 30 minutes and possibly up to four hours or so for the patient’s heart to stop beating. The patient’s loved ones may hear a few noisy breaths as the body shuts down. We will be there supporting the family and loved ones during that period and can help explain what may be happening as the patient passes away. 
  • Will patients soil the bed after ingestion or when they die?
    Answer: No, there is no involuntary release of body fluids during this process.
Being present

Most people prefer having two of our trained client volunteers present on the day they choose to take the medication. Emotions can be intense when someone is about to die, and it can help to turn the mechanics of preparation over to an experienced neutral person familiar with the process. It allows everyone else the opportunity to concentrate solely on their person and not be distracted by monitoring timing intervals between ingestion of the anti-nausea drugs and measuring and mixing the final medications, while still being present for their loved one. 

Experiences are as varied as individuals and families can be. Some people have a spiritual advisor offer a prayer or blessing. I’ve seen very quiet deaths where the volunteers withdraw to another room, leaving the group or family member alone at their request. I’ve been at deaths where the TV is on and everyone is reserved and not saying much. EOLCCA volunteers try to support their clients to have the death they want. Often the dying person is so ready for death they say things like, “Let’s get this show on the road.” Or, “I’m tired; I want to do this now.”

Mostly I’ve witnessed profound expressions of love such as: adult children and friends entwined with their dying person or stroking them tenderly, people singing to the dying, beloved pets snuggling next to their owners, last minute forgiveness amongst divisive family members, an aged  taciturn father apologizing to his middle-aged son for being too hard on him, and bikers regaling each other with tales of their escapades. The common threads are deep sentiments of love towards a cherished dying person.  

Dying man with wife
An honor

Afterwards, those present speak of grief, of thankfulness at being asked to be there for such an intimate experience, and recount stories about their now deceased loved one. EOLCCA has formed an online Bereavement Group specifically for family members involved in a MAID death, and we are able to offer them this option to help process their grieving.

All of EOLCCA’s 34 active volunteers consider it a privilege and an honor to help terminally-ill people, whether over the phone or in person, to have as much control as possible over when, with whom, and where they will die.

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Cynthia Tuttelman, an EOLCCA Client Volunteer, is a retired family physician and quilter living in Petaluma.

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help.  Thank you for your support!

Getting the Word Out About Dying with Dignity

At End of Life Choices California, one of our major objectives is to spread the word about all of the medical options Californians have at the end of their lives for dying with dignity, including (if they qualify) medical aid in dying. That objective is so important that it sits at the heart of our mission statement:
EOLCCA provides Californians the information and support to successfully navigate their legal end-of-life options.

7-toastmasters-get-the-word-out -resized

Knowing one’s choices is key

It continues to surprise us that few Californians take advantage of the End of Life Option Act. We understand that there are many reasons for that. For example, many individuals (including doctors) may not know about the law, or they may not support it on religious or other grounds. We just want to make sure that, at the very least, Californians know about the law so–if they qualify–they have the choice to use it.

With that in mind, I recorded a Perspective piece for KQED (the public radio station in northern California), about how the law clearly benefited one of our clients, along with mention about how few Californians use the law. By the end of 2021 (the last year for which we have usage data), less than a quarter of 1% of deaths in California resulted from using it that year. 

Looking at the raw numbers, in 2021, 772 individuals had prescriptions written, and 448 ingested and died from the drugs prescribed that year. NOTE: We always see a disparity between prescriptions written and ingestion because many people end up dying on their own–but feel great relief knowing they have the drugs if they need them.

If you would like to listen to my Perspective, here’s the link. And–hey–please spread the word!  Thank you.

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Stewart Florsheim serves on the Board of Directors of End of Life Choices California and chairs its Outreach and Education Committee. He has been an activist and leader in the end-of-life choice movement in California since 2003. During that time he was deeply involved in the effort to successfully pass the California End of Life Option Act in 2015. Stewart has given many presentations on end-of-life choice, including on radio and TV. 

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help.  Thank you.

Not in the Job Description, Bonus Benefits of EOLCCA Work

“All they really needed,” one volunteer said of a client’s family, “was an outsider’s ear and a little time.” The volunteer had come, after making an appointment on the phone, to talk over end-of- life choices. The client was close to death from cancer and wanted to know about using Medical Aid in Dying (MAiD). One of her adult children, though, was encouraging her mother to begin another round of a new chemotherapy drug.

“And there I was,” the volunteer said. “Not a doctor, not a therapist, just a volunteer with no  skin in this game. So I told them I could only answer questions about end-of-life choices but I’d be happy to listen. Then I sat down in a corner across the room.” For about an hour the mother and daughter talked; the mother saying she was tired of the pain and struggle, the daughter saying she “wasn’t ready” to lose her.

“Occasionally they would look at me,” the volunteer said; “asking about pain, or legal options, or time spans. At long last, the daughter gave her mom a hug and said, ‘I’ll support you, if this is what you want.’ It was a beautiful moment.”

daughter with mother turned to look at her smaller size
A cloud lifted

Another client told his volunteer, early on, that he was worried about his 65-year-old son. The son had been with his mother when she died, and a younger brother when he died. The son was emotionally fragile and his father thought that experiencing one more family death would be devastatingly difficult. 

Over the next several weeks, the volunteer visited with the son repeatedly at his father’s bedside and over coffee at a nearby bistro. After lengthy discussions about MAiD and how it works, the son became comfortable with the idea of saying goodbye to his father well before the latter took life-ending medications. “It was like a cloud lifted for both of them,” the volunteer said; “when it was silently agreed that I would be with the client if requested and the son would not attend his dad’s death. At the end of each visit both father and son would say goodbye with a lot of love and a little finality.”

Being a good listener

The neighbor of another volunteer, hearing she worked with end-of-life issues, asked her to help her daughter talk about them. Within a week, both mother and daughter had their long-postponed advance directives done.

Such experiences are common: times of tenderness for clients and volunteers alike. Clients and families get the care and relief they sought, while volunteers always learn a little more themselves – how to be a listener as well as a doer.

volunteer with patient
Ways we are able to help

One multifaceted happy outcome was experienced by founding board member and almost daily volunteer Lynne Calkins. Calkins took a call from David Timoner and directed him toward a hospice and eventual peaceful MAiD death for his dad Eli. “I remember talking with David about his concern that younger sister Rachel, a rabbi, might be against MAiD. In the end, of course, she was not. She totally came around in support of the family, and the End of Life Option Act. She continues to support MAiD and seeks to educate the Reform Jewish community.”

Eli Timoner’s story became an acclaimed documentary, Last Flight Home, written and directed by his daughter Ondi – one of the happiest bonuses EOLCCA has had in recent years.

These stories – of ways we are able to help, and to expand the benefits of end-of-life choice – are the extra joys that keep every EOLCCA volunteer’s spirits soaring.

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A lifelong newspaper and magazine writer, EOLCCA Board Member Fran Moreland Johns has published fiction, nonfiction, and several books. Her focus on end-of-life issues includes many volunteer years, numerous articles and one book, Dying Unafraid. She holds a BA in Art from Randolph-Macon Woman’s College, and currently blogs at Medium.com and franjohns.net. Her short story collection, Marshallville Storieswas released in April 2022.

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help Thank you.

Medicare wants you to talk to your doctor

You may not be thrilled to have “aged into” Medicare, but there’s a silver lining! Medicare offers significant support for communicating about your healthcare wishes and managing your end-of-life options. 

Talking to your doctor

Medicare also covers the cost of health services meant to improve quality of life when a cure is no longer possible: hospice care during the last six months of a terminal illness, and palliative care, to help manage a serious or terminal illness with a longer term prognosis.  As important – but not well used – is the fact that Medicare covers advance care planning discussions with your physician as part of your annual wellness check.

Advance directives

Advance care planning is something every adult is encouraged to do and complete while in good health, ideally well before a health crisis or terminal diagnosis. Often advance directives are prepared and health proxies determined at the same time as your estate planning documents and power of attorney and executors are finalized. Preparing your advance directives offers the chance for you to have invaluable conversations about your care management and end-of-life wishes with your loved ones as well as your physician, thanks to Medicare.
Medicare also requires hospitals and skilled nursing facilities to ask at the time of admission whether you have an advance directive and to note its existence in your medical record.

Without your documentation, providers who do not know you will be making health care decisions for you.

Palliative care

Palliative care is a notoriously underutilized health service that focuses on managing  pain and symptoms caused by chronic and debilitating illnesses. Under Medicare, palliative care is available to you whether or not you have a terminal disease, although it is most commonly used when you have decided to stop treating a terminal disease. Palliative care can increase your quality of life enormously. Because you’re no longer in such distress, palliative care also helps relieve the distress felt by your family and friends.  Medicare covers the costs of palliative care, so you should ask your doctor about it in order to take advantage of the relief it can offer you as soon as possible. 

 

Hospice care

Hospice is a combination of comfort care services including nursing care, palliative medicines, counseling for you and your family, and a supportive and knowledgeable resource for your immediate caregivers. The key benefit of hospice is being enabled to spend your last days in the surroundings of your choice – usually your home. If, like most of us, you want your death to be as peaceful and calm an event as possible, I encourage you to consider entering hospice as soon as your death becomes reasonably foreseeable rather than in a rush in the last few days.  

Because Medicare covers almost all the costs of hospice, there is no reason to delay once your doctor certifies that you’re eligible. This typically happens once you’re within six months of death, an interval that can be extended if death does not occur within that period.  

Where medical aid in dying (MAiD) fits in

If you live in California and are suffering from a terminal illness with a six months or less prognosis, the state’s End of Life Option Act enables you to request medical aid in dying from your physician. If you’re receiving hospice care, but the path towards death involves prolonged pain and suffering, you can choose to step off that path as long as you meet the legal requirements. To obtain medical aid in dying, you’re required to make two oral and one written request to your doctor; he or she confirms you’re within 6 months of dying; and a second physician must also confirm the attending physician’s opinion. After a 48-hour waiting period, your doctor is allowed to write your prescription for life-ending drugs. 

Even if you’re eligible for and obtain a MAiD prescription, you’re free to make whatever end-of-life plans you wish, including when, or if, you ingest the medication. For some, knowing the medication is there if needed, offers enough relief to let death take its natural course. It’s important to note that aid in dying medication is not covered by Medicare.

Since 2016, Medicare has greatly expanded the range of end-of-life services it covers. These end-of-life services enable you to learn about and choose the care options you want, and to spend the last months of your life with your family and loved ones as comfortably as possible.    

Note: Costs covered by Medicare may require a co-pay or deductible depending on the particular Medicare, Medicare Advantage, or Medicare Supplement plan you have. It’s well worth the time now to investigate what services are available and how you would want your care managed before facing a debilitating or terminal illness.

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Adrian Byam, a member of EOLCCA’s Board of Directors, has been thinking about and researching end-of-life decision-making for the last decade.  After retiring from a 40 year career as an entrepreneur and senior executive in the IT industry in 2012, he began a PhD program in neuroethics – a new field combining neuroscience and medical ethics – at the University of British Columbia (UBC).  His thesis showed that the choices made by surrogate decision-makers for ICU patients often failed to meet patients’ values, and suggested new ways to ensure patients’ autonomy is truly respected. Our social and medical systems today rarely inform us about the choices available to us in the last stages of our lives. By working with EOLCCA, Adrian hopes to help his fellow Californians learn about the choices that are legitimately theirs, and empower them to exercise control over the last days, weeks, and months of their lives.   

 

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help.  Thank you for your support!

Our First Line Phone Volunteers

Lynne Calkins remembers one call from a man whose terminally-ill father wanted to die – beginning a story that led to a movie. Last Flight Home, an acclaimed documentary released last fall, was described in one review as “boundlessly humane.” It’s a phrase that applies to the work of every first line phone volunteer who takes an incoming call to our number. 

First line phone volunteers, those who handle such calls and emails, are the invaluable gatekeepers to EOLCCA services. Calls come in – from the very ill, the troubled, the desperate, the anguished, and the curious – at all hours. They are responded to often within a very short time but always (when it’s after business hours) by the next business day.

Last year a total of 743 calls and emails were received and handled; an average of two inquiries per day or approximately 62 per month. The busiest months were January, August and October. A ‘staff’ of six trained first line volunteers divides up response duties, which means an average of ten new calls per week are handled by each volunteer. Calkins, the first line trainer, regularly reviews incoming messages on weekends and holidays too, in case an immediate response is necessary. “But thankfully, we have had no emergencies,” she says.

Each inquiry is unique

While few calls evolve into anything as dramatic as a documentary film, each is unique in its own way. Most commonly, that first call is simply “Can you help?” – but often it comes from someone in distress who heard about EOLCCA from a provider or after an online search. It’s the first line phone volunteer’s job to pick up on the caller’s needs as quickly as possible. It can be a big challenge to know what questions to ask and to listen carefully, but once front line training is complete each volunteer is prepared to meet it.

beth-macdonald-V2edkaIdMP4-unsplash (resized man on computer)


“I was worried that I might not be able to answer a question, or that there would be awkwardness on my part or the caller’s,” says first line phone volunteer Judith Bishop. “But that never happened. People have very straightforward questions, and are happy to talk. It’s just a matter of letting them know I’m available.” 

First line phone volunteers complete a two-week training on answering calls/emails and keeping records, in addition to the standard EOLCCA client volunteer training program. (Information is always confidential, but carefully recorded.) Calkins, a founding board member of EOLCCA, developed the training and frequently handles the inquiries herself. 

One recent day Calkins received a call from a woman with a terminal diagnosis who wanted to use the California End of Life Option Act. The caller was clear about her condition and her choice, but had no idea what to do, where to turn, what to ask her caregivers, how medical aid in dying works. Calkins was able to answer the caller’s basic questions and assure her that we would help her through her journey. During their conversation they talked about where the caller lived and Calkins realized an EOLCCA client volunteer lived nearby. Within hours she had made notes about the conversation, contacted the client volunteer manager and begun a connection between the two for more follow up support with a home visit if requested by the new client.

Services to all clients are free

While many calls are notable for efficient outcomes, others are more lighthearted. Bishop recalls talking with one clearly agitated woman with multiple questions and saying she’d get back to her first thing in the morning with more answers. “Oh no, dear,” said the now calmer caller, “I’m not a morning person.” Another caller, asking about costs of life-ending medications and medical care, commented, “You mean, I’ve got to pay to die?” 

EOLCCA’s services, at least – including 24-hour access to our phone line – are always free.

woman on phone
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A lifelong newspaper and magazine writer, EOLCCA Board Member Fran Moreland Johns 
has published fiction, nonfiction, and several books. Her focus on end-of-life issues includes many volunteer years, numerous articles and one book, Dying Unafraid. She holds a BA in Art from Randolph-Macon Woman’s College, and currently blogs at Medium.com and franjohns.net. Her short story collection, Marshallville Storieswas released in April 2022.

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help.  Thank you.

What MAiD Is, and What It Isn’t

Illness, dying and death can be troubling and fearful subjects. Not the kind of thing you bring up at brunch or over an after work beer. In a way that is too bad, these are things that happen to everyone, and by avoiding them, we give away much of our own power when we have to confront them.

Someone may find themselves at the mercy of perhaps well meaning, but not helpful, family members, caregivers or healthcare people. They may find their options and ability to decide what they want, and what they don’t, are chosen by others, and not necessarily the choices they would have made for themselves. There are lots of times in life when we don’t get to do as we wish; at the end of life, I would hope this is the one time when that person’s wishes are paramount.

The End of Life Option Act, a California law allowing medical aid in dying (MAiD) for the terminally ill under specific circumstances passed in 2016 (and subsequently updated very recently with some good changes), is a law that will allow you, under certain circumstances, to make the greatest choice of them all, that of how and when you will die. For all of us, death is inevitable, and most of the time, we don’t know when or how it will happen. For others, though, that fate is more clear and direct; a terminal diagnosis with a short time prospect. How to best experience that time is a direct benefit of MAiD.

MAiD is a gift

For someone facing an incurable cancer, an overwhelming neurological disease, relentless and increasing pain, yes, death will come, but only after extended suffering. For these folks, having lost so much thus far, having the right to choose when to die is a gift. With MAiD, this person, it could be you, one of your parents or relatives or even a close friend, can obtain medication that will painlessly end their life, when they wish and on their own terms. Not in a hospital, but at home, surrounded by the things and people that are important to them.

For anyone facing the uncertainty of death, having some say, control and dignity is a far better prospect than lying in bed, suffering and wondering when the end will come.

This gift is MAiD.

But isn’t that suicide?

Suicide is a charged concept, that of someone taking their own lives is sad and unnerving. MAiD is NOT suicide, it is not physician assisted suicide. MAiD is medical assistance in dying; it is the law that allows someone who is terminally ill with a 6 month or less prognosis to choose the day and time they will die, which is something that is going to happen for sure.

MAiD is not suicide, assisted suicide or euthanasia.

 

peaceful river scene
Having time for last goodbyes

MAiD is the managed time frame of an inevitable outcome; it is not any other intervention. Combining hospice and palliative care with MAiD allows someone the dignity and control they deserve. MAiD offers a sense of acceptance on personal terms that so many say they wish at the end of their lives.

There is the story of the man, terribly ill and in tremendous pain, his wife had passed previously and he was lonely and utterly miserable. His depression was profound and his family didn’t know which way to turn to help him. He was informed about the option of MAiD, which he had not known of. After learning about his qualifications and that this indeed was available to him, his family reported a total reversal of mood: he made his plans, relaxed into the time he had, and his last days were peaceful and calm.

To me, this is what MAiD really is: it is courage, choice and control. It is grace and peace and in fact true compassion.

I am very proud of these dedicated, caring volunteers from EOLCCA, who provide this deeply compassionate effort to those who want it. By addressing the huge question of how we live, and how we die, End of Life Choices California embodies the compassion each of us deserves at the most critical times.

Please follow us on Facebook or Instagram, sign up to receive our blogs and messages; you never know when this may become an issue and we are here for anyone who needs us at this critical time.

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Cindy Lauren is EOLCCA’s new Executive Director. To reach her directly, please email clauren@endoflifechoicesca.org

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help.  Thank you.

A Good Year

As 2022 winds down, I want to wish all our friends and supporters a happy holiday season and a wonderful New Year. I always find it illuminating to look back and review where we’ve been and what we’ve accomplished every year. I am pleased to share my thoughts with you again as we look forward to 2023.     

For a little historical perspective, the Founding Directors of EOLCCA came together with a dream, WAY back in early 2019. After the California End of Life Option Act (ELOA) passed, we each realized there was a huge unmet need to provide the people of California with information and support about end-of-life choice. We talked to our good friends at End of Life Choices Oregon, to see what they had done and how they had gone about starting a nonprofit to meet this very real need. We were told “OMG, don’t do it! It is a TON of work!!”.  Well, that didn’t stop us – it only lit our fire and got us going! And yes, it has been a ton of work. But it has been a labor of love with no regrets, and we all continue to be grateful to be a part of this growing, thriving nonprofit organization and community. We have now poured a foundation, put up the walls and a roof, and are starting to put in the windows and doors. It is a very exciting time for End of Life Choices California.

New Staff

One of the things I am most personally pleased about is the recent hiring of our first Executive Director, Cindy Lauren. She started a few weeks ago and we are already feeling the great benefits of adding her to our team. Cindy brings an invaluable depth of experience from years working with other health-related nonprofits in leadership roles. She has a keen understanding of capacity building, fundraising, growth management and volunteer programs. We are super excited to have her on board and you will be hearing from her soon. You can read about Cindy here on our website. Welcome, Cindy!

We also had another amazing new hire this year, Steffany Lohn, our Client Volunteer Program Manager. She comes to us with years of experience managing volunteer programs in direct service organizations. She has taken to End of Life Choices California like a duck to water, and we are delighted to have her on our team as well. You can read more about Steffany here on our website. Great to have you with us, Steffany!

Dedicated Volunteers

This year we enhanced our programs enabling our more than 40 volunteers to expertly manage over 700 direct inquiries from the terminally-ill and their families seeking help navigating their end-of-life choices. Physicians and social workers call us frequently for information on how to work with the California End of Life Option Act and we are honored to be able to support them in their work with their patients and often our clients.  More than 17,000 new users came to our website this year, up from 13,000 in 2021, as a result of our growing social media presence and focused outreach to senior living communities, LGBTQ groups, and religious institutions seeking to learn more about end-of-life options and the California ELOA.

pictured below right, SoCal Volunteers and below left, NorCal Volunteers

SoCal brunch
EOLCCA NorCal volunteers in Dec 2022

Our volunteers also provided numerous education programs (in-person and on Zoom) specifically geared to equipping both nonprofit and for profit hospice staff with the information they need to help their patients access the ELOA, and gave interviews and educational presentations in Spanish to the Latinx community. Our goal is to improve inclusivity and equitability to  marginalized populations that might not have access to great, or even adequate, end-of-life information and medical care. 

Having Options

That being said, I feel it is always important to remind people that we are not attached to any particular end-of-life path or outcome for any of our clients. There are MANY end-of-life options. The majority of the people who reach out to us are primarily interested in medical aid in dying. But sadly, many people still don’t qualify and we provide information and support on all the other end-of-life options. We continue to feel this work is vital and we will never only talk about medical aid in dying. Everyone, no matter their situation, deserves to have all the information available to them to make the choice that is right for them, and it is our commitment that everyone has access to this information.

Last Flight Home

Also this year, we were thrilled to see the launch of the award-winning film, ‘Last Flight Home’. It focuses on ailing Eli Timoner’s extraordinary life, as well as his ultimate wish to have a peaceful death with family by his side.  Searching for options for Eli, his son, David, quickly found EOLCCA’s website and called.  

Lynne Calkins, an EOLCCA Founding Director and volunteer answering the phone that day, took that call.  She was able to counsel David by explaining about all the end of life options his Dad might consider in his situation, including going onto hospice and requesting medical aid in dying under the California ELOA.  At his request, Lynne was able to give David the contact information for several hospices servicing his Dad’s home area, which she knew participated in the ELOA. This was possible thanks to the confidential in-house resources carefully built and maintained by our volunteers to help our clients obtain needed information quickly. (Lynne pictured at left with Ondi Timoner at a fall screening of the film.)

Lynne and Ondi at Santa Monica screening

The ‘Last Flight Home’ is a testament to the value of the California ELOA and to having access to factual information about one’s end of life options. The film is an excellent vehicle to raise needed public awareness nationwide about all the ways medical aid in dying laws enable peaceful death for both the terminally ill and their loved ones. It is absolutely a “must-see”!

You Make All This Work Possible

We are very proud of the work we do and are committed to expanding our impact throughout the state. The majority of terminally-ill Californians still do not know about the End of Life Option Act nor about what end-of-life options are available. Because of your belief in our mission, we have been able to keep our commitment to provide educational presentations as well as all services to clients and others at no charge, ensuring accessibility to all. As the year closes and you consider year-end donations, we hope you will consider making a gift to EOLCCA today; we rely on the generosity of caring people like you to make this work possible. Please know how thankful we are for your interest and support. 

In closing, I send out heartfelt thanks, as always, to our amazing Volunteers and our Board of Directors. We have made it a practice to be a working board, and we offer our volunteers many different ways to be of service in supporting our organization. Everyone jumps at the opportunity to keep the momentum going. And we have been very successful. We couldn’t help as many people as we do, and spread the word as wonderfully as we do, without them. Thank you.

Blessings to you all.

Happy Holidays and Happy New Year,

Judy Neall Epstein
President, Board of Directors

How We Help Our Clients

When I first joined EOLCCA’s Board of Directors, I decided to go through the volunteer training so I could get a handle on our core work: to help Californians learn about their legal end-of-life options, and to help facilitate their choices. The training was excellent. Afterwards, I spent several blocks of time  being “on call” – to answer initial questions and give people the resources and guidance they requested. I told my colleagues I would probably never “attend” a death because I had not done it before, and I wasn’t sure I was emotionally prepared. I did leave one small loophole: I would do so if other volunteers were not available and our client was ready to take the medication.

Severe pain

Well, that day came! We got a call from Kaiser Permanente’s End of Life Options Program with information about a patient who qualified for medical aid in dying and he wanted to take the medication as soon as it was delivered. Billy (the name I will give him) had cancer with metastases to his bones and brain. He was in severe pain. The medication was on order. He  lived alone and his only brother lives on the east coast. The Kaiser EOL coordinator asked if  EOLCCA volunteers were available to help him through the process.

Since most of our local volunteers were busy with other clients, I agreed to do it, with the understanding that a more experienced volunteer would be available to help me on the day Billy planned to take his medication. I was assured that would happen, since EOLCCA’s practice is to always have two volunteers attend a death together. 

Relieved and… grateful

I visited Billy a few days before he planned to take the medication. As someone who would be at his bedside on the day he takes the medication, I wanted to get to know him a bit, and I wanted him to feel comfortable with me. He gave me a short synopsis of his life. Since we were both avid readers, we exchanged information about our favorite authors. I also reminded him that at any point in time, he could simply decide not to take the medication. He told me that if he had had the medication at that moment, he would take it. He had thought a lot about it, and he was ready. He was relieved and grateful that he lived in a state where medical aid in dying is legal.

Still sure

On the day of the planned death, an experienced volunteer became available and we arrived in Billy’s room shortly after the Kaiser pharmacist hand-delivered the prescription. He had already explained the medication process to Billy. Billy took the anti-nausea medication, the first step in the medication protocol. We again reminded Billy that it was his choice to take the subsequent life-ending medication or not, but once he did, there was no turning back. He told us he was still sure of his decision.

volunteer at bedside
Having time for last goodbyes

Billy’s brother requested a final FaceTime visit with him to say good-bye, and Billy agreed. During that last conversation, Billy gave him some direction about his financial affairs, and asked about his nephew. His brother, somewhat stunned, told him how his nephew was doing and to just make sure he was as comfortable as possible. It was a tearful call, but an important one, and deeply appreciated by Billy’s brother.

After Billy took the final medication, he chatted with us, mostly about his love of books. After ten minutes, he fell into a deep sleep, and passed away peacefully in about an hour with the two of us by his side.

At the end of the day, I felt honored to have had the privilege to support Billy in his choice to use medical aid in dying, and to witness his passing. From the first phone call through the day of Billy’s death, we spent many hours on his case–and this is not unusual. I was also fortunate to participate in the very core of the work we do at EOLCCA: to help our terminally-ill clients find relief from their suffering, and achieve the peaceful, dignified death they want.

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Stewart Florsheim serves on the Board of Directors of End of Life Choices California and chairs its Outreach and Education Committee. He has been an activist and leader in the end-of-life choice movement in California since 2003. During that time he was deeply involved in the effort to successfully pass the California End of Life Option Act in 2015. Stewart has given many presentations on end-of-life choice, including on radio and TV. 

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California free of charge with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act. You can find comprehensive information on our user-friendly website. To support our work, or request an educational presentation, please visit ways to help.  Thank you.

Last Flight Home

“It was like light from a lighthouse,” says David Timoner of the call he got from End of Life Choices California (EOLCCA) when he and his family were facing the toughest time of their lives.

“The wisdom we got from those final days we will carry with us forever.”

LFH Oscar shortlist pic

David’s 92-year-old father Eli was in the hospital. He had reached a point at which advanced COPD, CHF, and other health issues had become intractable and meant he would have to transfer to a care facility. But Eli knew he wanted to die at home surrounded by those he loved, and he asked about medical aid in dying. His family understood and supported his decision but didn’t know where to turn for help. Vaguely aware of a California law, they still had no idea what to do next.

“The day is a blur,” David says. “I think I googled something like ‘How to end your life legally . . .’ and EOLCCA popped up right on top. I called the number, left a message, and had a call back within the hour.” Lynne, the volunteer at the other end of the phone, was everything David needed at that moment: “Calm, empathetic, and with the answers to all of our questions. Lynne explained how the California law works and reviewed the eligibility requirements.” These, in brief, include the requirement that the patient must be diagnosed as terminally ill, with a six month or less prognosis by two doctors, must make the request himself, be able to self-ingest the medications, and be of sound mind. “Lynne also recommended that my father consider enrolling in hospice care,” David says. She was able to recommend two hospices in our area that she knew had doctors who participate in medical aid in dying. We chose one and brought Dad home.”
Ondi Timoner, an award winning documentary filmmaker, decided to record those days during the then 15-day waiting period mandated after Eli first requested aid in dying medication from the hospice doctor, until he could receive the prescription. She initially intended just to have a family remembrance. After all was over, however, she realized she had the makings of something important.

Ondi’s remarkable film, Last Flight Home, tells the full story. In the ensuing weeks, the Timoner family – Eli and his wife Lisa, their children David, Ondi and Rachel, their grandchildren and friends–would spend invaluable time at home together celebrating Eli’s unique life’s journey. The profound, intimate, loving farewell afforded Eli and his family by California’s medical aid in dying law, is the outcome we at EOLCCA wish for anyone who reaches out to us for similar help and information. That this Southern California family’s experience would be recorded by daughter Ondi and edited into a powerful documentary now being released to widespread acclaim, is a visual testament to the value of medical aid in dying.

At a screening in New York, daughter Rachel told a New York Times interviewer, “And then there is the idea that this film could change laws.” Many of us with EOLCCA worked hard to get the California law passed, and we continue to support expanding the law throughout the U.S. To have had a part in helping Eli Timoner and his family gain peace at his life’s end, and to know that they now join the fight for everyone to be able to make such a choice, is doubly gratifying for EOLCCA.

California is one of a small number of states fortunate to have a law which enables its residents to access this compassionate end-of-life option for the terminally ill. But, from call after call we receive every day, it’s clear that few terminally-ill Californians are even aware of the law, or know enough about it to even begin the process of requesting medical aid in dying from their physician.

Last Flight Home is a film we hope will receive all the top accolades in the film industry for its many-layered and beautiful story. The story behind the film has been well documented in the New York Times. It is one we urge our readers to see as soon as possible and then recommend to friends and family everywhere.

‘Last Flight Home’ is a film we urge our readers to see and recommend to friends and family everywhere.

EOLCCA Lynne with 'Last Flight Home' Director Ondi Timoner and family

From Left to Right: Lynne Calkins with Ondi Timoner, Rachel Timoner, and Lisa Timoner at a recent screening

Asked for advice she might now pass on, Ondi says simply, “Be with your loved ones now. Don’t wait for them to be dying. But there is an incredible quality of life when a person is transitioning. The wisdom we got from those final days we will carry with us forever.”
Perhaps the most profound lesson Eli’s family learned was the simplest. It has to do with summing up life itself – as we humans do so often by looking at accomplishments and honors and all those treasures we accumulate. But no, says Ondi Timoner as she reflects on her family’s journey and the creating of Last Flight Home.

“Look at it as a way to measure our lives,” she says. “Measure our lives with love.”

We hope Last Flight Home will reach the countless families and individuals in situations similar to that of Eli and his family, so that others may learn about the California law in time to make a difference in their own end of life if facing a terminal illness. Our EOLCCA volunteers are always ready to help. Call us at 760-636-8009 or visit our website.

Click here for more information about the film director, Ondi Timoner, and Interloper Films.

Click here to stream it on Paramount+ 

Paramount+ logo

 

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A lifelong newspaper and magazine writer, EOLCCA Board Member Fran Moreland Johns has published fiction, nonfiction, and several books. Her focus on end-of-life issues includes many volunteer years, numerous articles and one book, Dying Unafraid. She holds a BA in Art from Randolph-Macon Woman’s College, and currently blogs at Medium.com and franjohns.net. Her short story collection, Marshallville Stories, was released in April 2022.