On mortality: Workshop will offer insight into end-of-life care

Last year, hundreds of islanders attended a four-day event focused on death and dying. Next week, the same team of people who created that opportunity will offer a one-day workshop on palliative care — care that provides relief from the symptoms of life-limiting illnesses, such as pain and physical and mental stress.

The group of seven women behind the effort are encouraging islanders to reflect on our shared mortality and take action to do advance care planning and complete advance directives. As they set about planning this year’s event, organizer Carol Spangler said they talked about how there is considerable fear and anxiety about the physical and existential pain that often accompanies death.

“We talked about if there are ways that we might go through this end-of-life process that may be less stressful and painful. That is how we came to palliative care,” she said.

The workshop they organized includes some luminaries in the field who will provide an array of information on evidence-based practices and methods to help improve the quality of life at the end of life for both patients and families. The information provided will range from traditional Western medical practices to complementary approaches, such as self hypnosis and mindfulness, to the medical use of cannabis. And, organizers say, because this is Vashon — where countless residents are devoted to their animals — the day will include a session led by two veterinarians.

In fact, the line-up of the day, titled “Unraveling the Mysteries of Palliative Care,” is so strong that some medical professionals plan to attend and earn continuing education credits, Spangler said.

In addition to the speakers, there will be trained facilitators on hand to help participants complete advance directives — to think about and record their wishes for end-of-life care and decision-making.

Vicky Boyd, a fellow organizer of the workshop, stated her goal for the day.

“We really hope this will change some people’s minds about how they deal with the end-of-life,” she said.

The day’s schedule will be as follows:

• 10 to 10:30 a.m. Welcome and Overview of Day

• 10:30 a.m. to Noon Keynote: The Palliative Care Tool Kit – Benefits for Patients, Families, Staff

Carol Kummet, LICSW, MTS, University of Washington Medical Center Palliative Care Program;

• 12:30 to 2 p.m. An Integrative Medical Approach to Management of Pain and Anxiety: the Body-Mind Connection

Kathleen Sanders, FNP-BC, MPH, Integrative Nurse Practitioner, Seattle Cancer Care Alliance;

• 2 to 3:30 p.m. Vashon Cannabis Conversation: Taking the Mystery Out of Marijuana

Dr. Sunil Aggarwal, M.D., Ph.D, FAAPMR, Integrative Pain, Palliative Care, Hospice and Rehabilitation Medicine;

3:30 to 5 p.m. Comfort Care for Animals and Their Companions

Tag Gornall, DVM and Tim Kraabel, DVM.

Reviewing each of the speakers, Boyd and Spangler said that Kummet, who will deliver the keynote address, is highly regarded and has more than 20 years of experience in the grief and bereavement field. Organizers have been told to expect people from off-island to come simply to hear her.

Sanders is also highly respected in her field, with a focus on an integrative approach to care. She will provide information and provide a time for people to try some of the modalities she will discuss, such as guided meditation and reiki.

The third speaker of the day — and the final speaker in the lineup before the veterinarians take the floor — holds doctorates in medicine and medical geography. Materials about the day indicate he is as an integrative pain, palliative care, hospice and rehabilitation medicine physician in private practice at SAGEMed in Bellevue and is an on-call medical physician with MultiCare as well as the associate medical director of MultiCare Hospice.

Organizers say they worked hard to find someone to address the role of cannabis in palliative care and to find someone like Aggarwal, who relies on evidence-based practices, is well published and prescribes cannabis in his practice.

Spangler and Boyd also expressed appreciation to the panelists, who could command high fees, but are speaking on Vashon for a greatly reduced honorarium or for free.

Finally, for the animal-focused portion of the day, organizers credit veterinarians Tag Gornall and Tim Kraabel with providing an extremely well-received talk at last year’s event. The men will be back this year to recount stories of providing care for animals at the end of their lives as well as comfort and compassion for the humans involved.

Before the organizers held their event last year, one of the women, Berneta Walraven, noted that in LaCrosse, Wisconsin, 96 percent of the city’s 50,000 people have signed advance directives. LaCrosse is unusual, as statistics show that most people have not done so. In fact, a 2013 survey of The Conversation Project found that while 90 percent of people say that talking with their loved ones about end-of-life care is important, only 27 percent have actually done so.

The organizers of these events are undeterred and are working toward Vashon surpassing Lacrosse. In fact, trained facilitators are working with seven congregations on the island to help members think about and write down their end-of-life wishes.

“That is no longer pie in the sky that all people on the island would have advance directives,” Boyd said.

Spangler stressed that such directives can be altered if people change their minds, but they are useful to both the patients and their families when the end of life comes and provide needed clarity for all involved.

Both women say they hope the upcoming event will help people learn more about options they might want to have for themselves when death is approaching.

“We are fostering this idea that you want to die the way you want to die,” Boyd said. “We want to make the end of your life as palatable as possible.”