For every book, no matter how long, the last page inevitably arrives. The pages in your left hand get bigger as the stack on the right slowly diminishes, like an evaporating rain, or like time itself. For many readers, we think about how it is going to end, imagine the possibilities, and even look forward to it. But many of us don’t do the same with life itself. Because we try not to think about the end, we don’t look rationally at the decisions that lead up to it, and the best ways to take care of ourselves. We know that the last part of the story isn’t the only one, but we sometimes ignore how important the right ending really is.
That’s why in late May, Institute on Aging held a panel discussion titled “ENDINGS MATTER: A Conference On End of Life and Palliative Care Choices,” at St. Mark’s Lutheran Church in San Francisco. The all-day conference featured a variety of speakers discussing how to handle the important questions that come when looking at the end of life, from legal, medical, and ethical perspectives.
Involving the Community in Their Most Important Decisions
A large and interested crowd of 216 attendees gathered at St. Mark’s to hear from experts across a wide range of disciplines, who discussed what it means to be thinking honestly and clearly about the end of our lives. We started the day with a panel discussion on the Influence of Faith, where religious leaders from a number of different faiths talked about what preparing for death means to their respective traditions. Not in terms of what comes next, but about the preparation, and what it means to have a good ending, one that is filled with the dignity you’ve accrued throughout life. This discussion was led by the pastor of St. Mark’s, the Reverend Elizabeth Ekdale, and the panel included Kamal Abu-Shamsieh, Chaplain at Stanford Hospital; Fr. Timothy S Godfrey, USF; John Martin, Spirit Rock/Insight Meditation Society trained teacher; Dr. Bonita Palmer, formerly of CPMC; Kaushik Roy, E.D. of The Shanti Project; and Rabbi Eric Weiss, of Bay Area Jewish Healing Center.
“A beautiful demonstration of how we are all the same, even though we are on different spiritual paths…Bravo!”
From there, we had two fascinating breakout sessions. In one, Molly Bourne, MD, the Chief Medical Officer for Hospice by the Bay, talked about the role hospice can play for the elderly and the terminally ill. As this option becomes more popular, the people of the community have more questions about how they can make hospice work for them.
The other breakout session was about California’s new End of Life Options Act, which allows for physician-assisted death under a very strict set of guidelines. This discussion, led by Phillip Batchelder, JD, from Mitchell and Courts, Stefanie Elkins of Compassion and Choices, and Teresa Thomas, PhD, a neuropsychologist, dealt both sensitively and bluntly with this emotion-fraught topic. Choices like these will play a larger role in how people face the end in the upcoming years, so having a full and clear understanding of it is vital.
Following lunch, we enjoyed two more breakout sessions, one of which saw Roy Remer, the Director of Guest House Facility and Volunteer Programs at the Zen Hospice Project, talk about “Death Cafes,” “Death Dinners,” and other conversations about death, where people can speak freely about their thoughts, fears, and plans around dying—encouraging a spirit of openness for a subject many don’t like to talk about save for small whispers and dark humor to mask the fear. The other session, hosted by Susan Goodman Goldstein, Clinical Supervisor at Institute on Aging, and Karen Storey, an Advance Care Planning Facilitator for Coda Alliance, gave people the tools they needed to fill out living wills and deal with the other paperwork that accompanies death.
“Loved the content and resources presented…really made me want to host a death discussion.”
Following the breakout sessions, the final panel discussion of the day was “The Quality of Life’s End: A Medical Perspective.” In this session, led by Dawn Gross, MD, PhD, Host of KALW’s “Dying To Talk” and member of the UCSF Palliative Care Team in SF Dept of Aging and Adult Services, a group of experts talked about the medical community’s approach to death, how they handle it, and what they expect in the future. This panel, which represented CPMC, Kaiser, and UCSF, was comprised of James Davis, MD; Shoshana Ungerleider, MD; and Marilyn Williams, MS, RN. Promises and failings were discussed, and everyone recognized the need for a growing awareness that death is not just something to be staved off for as long as possible, but something to be treated with compassion and care, so that the end has as much dignity as the beginning.
Final Lessons
The day ended with a talk by Dr. Patrick Arbore, the Founder of IOA’s Friendship Line, and Director of IOA’s Center for Elderly Suicide Prevention. In his talk, titled “Endings Matter: Grief, Loss, Support, and Choices,” Arbore stated, “Losses today are more frequently of a type known to contribute to complicated mourning.” He then proceeded to address how assorted influences are factors in end-of-life choices and fears—and how we might better confront and cope with these influences.
Throughout the day, we had a wonderful and open discussion about the choices we face at the end of life, from a multitude of perspectives. How we view death influences how we approach it, which can even influence how we handle the paperwork. It is all tied together, and the community that deals with the people’s endings is coming together to create a new understanding of what is needed.
“This was the best conference I’ve ever attended. More on this topic, please.”
This is the story we all write together. We all know that the book will one day close, but we rarely want to talk about the last chapters. We know that endings matter, that a great story with a bad ending will be diminished. With events such as these, Institute on Aging hopes to create a new way to look at the end, for older adults, for the terminally ill, and for everyone who loves them.
At Institute on Aging, we run programs to help everyone understand aging, death, and grief, and to create a stronger community to work with these issues. Some of these services include:
- A Drop-In Traumatic Loss Grief Group 10:30 a.m.–Noon on Saturday mornings (No fee)
- 8-Week (Basic) Traumatic Loss Grief Group. $25.00 per session
- 8-Week (Advanced) Traumatic Loss grief Group. $25.00 per session
- Monthly Traumatic Loss Grief Group for participants who have completed the Basic Traumatic Loss Grief Group
- Individual Grief Counseling. Sliding Scale fee
- Grief Trainings are available upon request
- Psychology and Counseling Services, available in one’s home or at IOA offices. Psychotherapy is offered at $50 per session for all clients. Sessions may be covered by MediCal, MediCare, and most health insurance carriers.
For additional information about IOA programs and services, contact IOA Connect at (415) 750-4111.
