Los Robles Hospice – Live in-person presentation

Live in-person presentation for hospice Social Workers, RNs, Bereavement Counselors/Chaplains, and other interested staff

Join representatives from End of Life Choices California (EOLCCA) for this timely and informative in-person presentation for hospice social workers, registered nurses, bereavement counselors, chaplains, and interested staff on advance care planning, updates to the California End of Life Option Act, barriers to medical aid in dying, and ways that hospice can support those who opt for using this legal method to die with dignity and on their own terms.

The presentation will cover such topics as
  • Advance care planning – Advance care planning is a process that enables individuals to make plans about their future health care. Advance care planning is applicable to adults at all stages of life. Participation in advance care planning has been shown to reduce stress and anxiety for patients and their families, and lead to improvements in end of life care.
  • Updates to the California End of Life Option Act – as of January 1, 2022:
    • The new bill reduces the waiting period between the required two oral requests to 48 hours
    • Healthcare systems and hospices now have to post their aid-in-dying policies on their websites.
    • The final attestation form is no longer needed.  
    • When a terminally-ill patient requests MAID and their physician does not wish to participate, the physician is now required to tell the patient and must document the request and transfer the patient’s medical records upon request.
    • The amendment also clarifies that MAID medication can be taken within a healthcare facility.
  • Eligibility Requirements for MAID – Must be 18 years or older; Must be of sound mind and exhibit appropriate decision-making capabilities to the attending physician; Must be able to self-ingest the medication either orally or by pushing through an NG tube; and Must be diagnosed with a terminal disease, with a life expectancy of six months or less, by two physicians.

For more information about this event contact Los Robles Hospice.
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End of Life Choices California

Visit EOLCCA’s Hospice page for more information about this important service.

Hospice is a philosophy, not a place, which provides compassionate comfort care at the end of life. The goal is to maintain or improve quality of life for someone whose illness, disease or condition is not going to be cured, and from which there is no anticipated recovery. Each patient’s individualized care plan is designed to address the physical, emotional and spiritual pain that often accompanies terminal illness. Hospice care also offers practical support for the family during the illness and grief support after a death. For those who have an appropriate medical referral, the cost of hospice care is usually covered by Medicare, Medicaid or a third party insurance.

End of Life Choices California provides Californians the information and support to successfully navigate their legal end-of-life options.

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.

9 Good-looking Men: End of Life Choices and the Importance of Planning Ahead

This presentation is for “9 Good-looking Men,” a private group that meets weekly in San Diego.

This presentation by End of Life California (EOLCCA) Founding Director Lynne Calkins  will include options available to those at the end of life including of Medical Aid in Dying (MAiD); issues, concerns, and barriers sometimes encountered on patients who choose to exercise their legal rights relating to end of life; and the importance of advance planning.

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!

NCAAWA Women’s Conference: “The Elephant in the Room” Advance Care Planning

2023 North County African American Women’s Association Women’s Conference, Sisters Soaring!

Many of us realize that we should plan ahead to address possible health care crises or other events, but for various reasons, we put it off.  Like the proverbial “elephant in the room,” we just pretend it’s not there.

If you or someone you love falls into this category, plan to attend this hour-long workshop with Lynne Calkins, a Founding Director of End of Life Choices California (EOLCCA). Are You Good To Go? End-of-Life Planning Made Easy. Thinking about this topic can be really scary; this will be a safe, fascinating and interactive workshop. You’ll discover the importance of opening up conversations with your spouse, partner, parents, grandparents or your adult children about the value and gift of advance planning for end of life. All end-of-life choices available in California, including medical aid in dying will be explored.