Whatcom County makes plenty of lists for being a great place to live.
Marie Eaton wants to make sure it’s also a great place to die.
Eaton, 68, is a professor at Western Washington University’s Fairhaven College who teaches a course on death and dying. She’s also a member of an end-of-life task force working to ensure that people facing death in Whatcom County know their options and have a strong network of care providers and resources to help them.
“In the same way you might plan for birth or a wedding or other large life events, you can plan for your death and make it more like you want it to be,” Eaton says.
Death is inevitable, she says, but it’s a stage of life that too many people are afraid to think about, talk about, and plan for.
“As I think about the stages of my own life, there’s a time for education, there’s a time for family, there’s a time for career building. As we age, part of our job is to help each other die well,” Eaton says. “Our society doesn’t do a very good job of supporting that.”
That lack of planning has consequences — emotionally, physically and financially.
“A lot of the cost of health care happens in the last three or four days when heroics, often pointless heroics, are being undertaken to keep someone alive at all costs,” Eaton says. “If you had talked to that patient earlier, before the medical crisis, they likely would have said, ‘If I can’t recognize my family, I don’t want to be alive; if I have to be fed through a machine, I don’t want to be alive.’ Because people don’t have those conversations, the medical profession is left with this responsibility to try everything.”
Getting the community to talk openly about death and end-of-life care is just one of the goals of the task force that was convened by Whatcom Alliance for Health Advancement last spring with grants from RiverStyx Foundation and Whatcom Community Foundation.
Over the past year, the task force has also worked to document local end-of-life and palliative care resources and to identify gaps in coverage. Task force members tackled a variety of topics, including the way local caregivers, nurses and doctors deal with end-of-life care; advanced-care planning; building stronger community-based palliative care; and how to do it all in a way that’s financially sustainable.
“This is an issue that isn’t just important in Whatcom County,” Eaton says. “It’s an issue for all of us. Life is a terminal illness; we’re all going to face it some day. Let’s hope we can do it with a little grace.”
Eaton hopes to build a community that is open about discussing the choices they want made at the end of life. One of the goals set by the task force is for 60 percent of people over 65 to file advanced directives, which document a person’s preference for end-of-life medical treatments, by 2016.
Other goals include training for clinicians and care providers, partnerships between care facilities, more community-based palliative services, improved end-of-life care at nursing and long-term-care facilities, and creation of a website about local end-of-life resources. The site should be up and running this year.
While making the community a better place to die might seem an unusual or uncomfortable task, Eaton has found hope in what she has seen. Whatcom County has a strong hospice program, she says, and the people she has worked with through the task force are all passionate about caring for patients.
“Hopefully, the work we’re doing together means that, when it is my time, the palliative community will be there, and hopefully I’ll be able to die the way I want to die, and the choices I make about my own end of life will be honored,” Eaton says. “I faced some of my fears of death when I started teaching about it. I’m not afraid of dying. I’m more afraid that my wishes will not be honored or that I’ll get on some medical care conveyor belt that I can’t stop when I want to stop it.”