Zen and the Art of Dying Well

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Right-to-die advocate dies without reprieve: San Mateo resident Jennifer Glass fought for new legislation

By Samantha Weigel

Just months after urging the California Legislature to empower her to cease her suffering on her own terms as she battled an aggressive form of cancer, Jennifer Glass died in her San Mateo home Tuesday night.

jennifer-glass
Jennifer Glass died in her San Mateo home Tuesday night after battling stage 4 lung cancer. Glass had sought changes to state legislation so she could have controlled how she died.

Despite her condition, the 52-year-old was an active advocate for Senate Bill 128: End of Life Option Act and her supporters remain saddened the legislation, which could have allowed Glass to avoid more suffering, stagnated in the Assembly.

A former communications specialist who took charge of high-power campaigns such as for Facebook and Oracle, Glass turned her attention to the state’s right-to-die initiative after being diagnosed with stage 4 lung cancer in 2012, just four months after marrying her husband Harlan Seymour.

A national spokeswoman for the movement who worked closely with the advocacy group Compassion and Choices, Glass died while California lawmakers stalled on a right-to-die law. SB 128 would give patients who are terminally ill the right to terminate their own life after completing a series of checks and balances with doctors and mental health professionals.

Glass fought to extend her life through chemotherapy as well as radiation and even did better for a time; however, a CT scan taken in June of this year showed her cancer had spread to her lungs, liver, abdomen, pelvis and brain. Unable to tolerate chemo, she decided to die at home, Seymour said.

As her lungs filled with fluid making breathing difficult and her pain increased, Glass opted to undergo palliative sedation — a process in which she is medicated into a coma then nutrition and fluids are withheld until the patient dies from the disease or dehydration.

It took her more than five days to die, a disheartening time marked by her awaking from the coma in a panic one evening, Seymour said.

“By the time she started palliative sedation, she was in so much pain, she really couldn’t say goodbye to people. If there was an end-of-life option, she could have started earlier, even just one day, she could have said goodbye to her loved ones and had a quiet death,” Seymour said. “Palliative sedation is really just a slow motion version of what the end-of-life option offers. Instead of a seven-day, dragged-out death in a coma, it’s a death that could just last a few hours and allows for a better ending with one’s family. … It would have been a great comfort to her if she had the choice to end her life in a faster manner. She would have suffered less.”

Had SB 128 been enacted, Glass would have been able to obtain aid in dying through prescription medication that she could have taken at home allowing her to die in her sleep, sometimes in as little as 30 minutes — as in the case of Brittany Maynard, a 29-year-old Bay Area resident who moved to Oregon to exercise her right to die, according to a press release from Compassion and Choices.

Opposition

Opponents say SB 128 could have unintended consequences as insurance companies looking to cut costs or those without good access to health care may be more inclined to use these types of laws.

“The concerns of our coalition, there are many but primarily, is that you cannot base broad public policy decisions on one case, you have to look at all of California and not just a single individual or a narrow group of individuals,” said Tim Rosales, spokesman with the Californians Against Assisted Suicide. “Consider how these policies would impact everyone in a state as diverse as California; particularly in parts of California where people do not have access to the types of health care where they can get second and third opinions or access to better treatment.”

Rosales noted many states across the country turned down legislation dealing with the issue this year and instead, California should focus on making hospice and palliative sedation more accessible.

Another option

While opponents often cite palliative sedation as a suitable alternative, representatives from Compassion and Choices argue Glass’ case proves it didn’t allow her to die peacefully.

“With Jennifer, it obviously did not work as effectively. … It’s really important for people to understand that in reality, palliative sedation does not work for everyone and those folks need another option. Medical aid in dying is that option,” said Toni Broaddus, campaign director for Compassion and Choices California. “In that sense, this legislation is really somewhat neutral because it doesn’t tell anyone what they have to do at the end of their life, but it says you can have all the medically possible options out there at the end of life. Public policy, and this is good public policy, I think is for the state not to be telling people they can’t have access to a service or prescription that many other states are using.”

Glass’ family agreed adding palliative sedation is not as dignified and can be much more painful for both the patient and their loved ones. Glass’ sister Mavis Prall noted it was not the quick nor peaceful option she was fighting for.

“She did not want her loved ones to have to watch the life drain from her over a five-day period, nor to watch her lose all dignity as her body slowly shut down,” Prall said in the press release. “Members of the California Legislature should be aware that their inaction has painful consequences. I urge them to pass the End of Life Option Act this year.”

Glass publicly spoke in support of SB 128, co-authored by state Sen. Bill Monning, D-Carmel, as she fought to provide those who are suffering with a choice.

‘Keep fighting’

Glass had been scheduled to testify in the Assembly’s Committee on Health July 7 but the hearing was canceled and has yet to be rescheduled. Broaddus acknowledged while SB 128 easily passed the Senate, there weren’t enough votes in the Assembly. Yet as Glass requested, they will continue to advocate for the bill to be adopted this year, Broaddus said.

“Her message to us had been ‘keep fighting, don’t stop fighting,’” Broaddus said. “This issue is very very personal for people. Despite what it may appear, it does not break down party lines or ideological lines. It’s something people look at very personally based on their own experience.”

Sen. Monning expressed his condolences while noting SB 128 is still in action.

“My heart goes out to her family. We will continue to pursue Jennifer’s commitment to establish the right of terminally ill patients to have all end-of-life options made available to them,” Monning wrote in a press release.

Legacy

Seymour said he would continue to support the right-to-die movement that could have spared his wife from further suffering and prefers she be remembered as a strong, loving and logical woman.

“Jennifer was very worried about suffering greatly in the process of her death, and she was concerned about what it would do to her loved ones. She didn’t want to die drowning in her own lung fluid and that’s essentially how she died,” Seymour said. “If you allow palliative sedation, there’s no reason not to allow a faster, less traumatic, less painful way of going as well. … I really want to see Jennifer’s legacy and her dream of having an end-of-life option come true.”
Complete Article HERE!

Cancer Death & Dying: I Don’t Want to Die and I Don’t Want It to Hurt

Fear of death and dying is explored by a two-time cancer survivor. There are benefits to taking a moment to look at these fears today.

By Barbara Tako

The fear of death and painful dying is in my face, for me and I suspect for other cancer survivors too. It is natural and normal to have these concerns, but rather than avoid death worries, it may be reasonable to take a deep breath and face those thoughts a bit. Maybe the fear can be reduced if we contemplate and explore death for a moment.Barbara Tako

I don’t want to die. Who wants to be separated by death from their loved ones? I also don’t want to go through chemotherapy again. I don’t want to lose my hair again. I don’t want to be set apart from the people I care about. I don’t want to suffer again. I don’t want the “long goodbye.”  I also visualize the long goodbye as a lingering and painful death with my loved ones nearby watching me be upset. Who wants that? How can we cope?

When I talk to other cancer survivors, they often tell me that they, like me, are more afraid and worried about a painful lingering death process than death itself. I decided to talk to some palliative and hospice care people, as well as my psychotherapist. Let’s look these huge issues right in the face.

Dealing with the possibility of death or a long painful death directly with honesty has the potential to help the coping process. Death is terribly huge and frightening. Our culture likes to bury the reality of death and, for the most part, much in the way of discussion or preparing for death. Why not work on preparing instead?

The medical professionals that deal daily with these situations say there are now a lot of excellent drugs out there to help people manage end-of-life pain. They also say, most of the time, they can keep a dying cancer patient pretty comfortable. I felt calmed to hear that and I still don’t want to die. No one wants to die. The reality is that death will happen to everyone, sooner or later.

The psychotherapist I spoke to approached it differently. She said people facing end of life who haven’t reflected before on their own death might feel angry and cheated or afraid of the dying process. To me that makes sense. Who wouldn’t be angry and bitter to have their life cut short by cancer? Yet, she said people facing death in their eighties and beyond can feel this way too.

She said sometimes people have unresolved relationships and issues. I saw a clue in her words. The point of contemplating death is to live deeply now and make conscious choices about how you want to try to approach your death. I don’t want to be jealous, angry or afraid at the end. Those are awful feelings. What to do? Face those issues and feelings today, resolve my cancer anger and fear, deal with it, and cope with it now. Live my life deeply, now.

I have resolved to try to do better at my relationships where possible—to be more honest and loving with the people around me. I won’t always succeed. I am human, but thinking about these end-of-life worries motivates me to try harder. I don’t want to die bitter and angry about “unfinished business.” No one probably feels everything is “done,” especially if death comes sooner rather than later, but why not work on death today?

What else? I have decided to actively practice gratitude. I have had some awesome life experiences. I have a very nice life compared with many people in this huge world. I have so much to be grateful for in spite of having two cancers, and I will try to remember that and to focus on that. I will try to slow my life down where I can, prioritize better, and live deliberately. This fall I am going to explore yoga and meditation. Meditation helps slow my life and my racing thoughts down. It helps me to live in the moment and to live more pleasurably, deliberately, and deeply. I will also continue to add to my bucket list and try to work on those items too.

Finally, I will try to keep the faith. Whatever your belief system is, try to hang onto it, grow it, and receive comfort from it. That means, for me, I need to practice my faith on a daily basis. I read. I pray. I talk to God (sometimes I yell or rant). I try to create stillness inside me where sometimes I hear answers in the quiet of my soul.

In truth, none of these thoughts are a complete answer. There are books and books written about death and dying. Right now, I am grateful that I am not facing end-of-life issues today. I don’t truly know what that feels like. It does help me, though, to spend some time looking at these worries and fears in the face and to spend some time thinking about my plan.

Facing uncertainty with a plan, for me, is better than facing it with nothing at all. The best plan would be no pain and no death, but that is not how our world works. I know this is probably a naïve approach when looked at by people with advanced cancer. It is the best I can do with my hopes for all of us, and my (gratefully) limited perspective, and my lingering fear of recurrence and what recurrence might mean. What are your plans? What works for you?
Complete Article HERE!

After surviving the Holocaust, letting go of life is complex

By Melissa Apter

A Holocaust survivor looks at a candle commemorating the liberation of Auschwitz Birkenau, January 27, 2015, in Ayr, Scotland. (Jeff J. Mitchell/Getty Images)
A Holocaust survivor looks at a candle commemorating the liberation of Auschwitz Birkenau, January 27, 2015, in Ayr, Scotland.

Jewish hospice chaplains confront the emotional and medical complexities of death and dying every day, but Holocaust survivors present special challenges.

Rabbi E.B. “Bunny” Freedman, director of the Jewish Hospice and Chaplaincy Network, said that chaplains are increasingly being called on to provide spiritual support to survivors and their families.

“There are a lot of complex issues,” said Freedman, who has worked in end of life chaplaincy for 23 years. “One of them is making the decision of unhooking hydration – much more complex for a Holocaust family. The idea of not providing nutrition is crossing a sacred or not understood emotional line.”

Survivor guilt and mixed feelings at the prospect that they may “meet their relatives on the other side” commonly surface, he said.

Rabbi Charles Rudansky, director of Jewish clinical services at Metropolitan Jewish Health System’s hospice in New York, reported similar experiences with Holocaust survivors he had counseled.

“Last time they saw their loved ones was hellish, hellish, hellish, and now they’re crossing that bridge,” said Rudansky.

Some Holocaust survivors are apprehensive at that prospect, he said, while others are “uplifted.” A usually talkative person may fall silent, while a quiet person may suddenly have a lot to say.

“I’ve been called in by Holocaust survivors who only want to speak with me so some human ears will have heard their plight,” said Freedman.

Jan Kellough, a counselor with Sivitz Jewish Hospice and Palliative Care in Pittsburgh, said she encourages, but never pushes, survivors to share their stories. While it can be therapeutic for some survivors to talk about the Holocaust, she said, it is problematic for others.

Rabbi Freedman giving a presentation to hospice workers in Baltimore, Maryland, spring 2015. (Courtesy: Dr. Gary Applebaum)
Rabbi Freedman giving a presentation to hospice workers in Baltimore, Maryland, spring 2015.

For some survivors, “there’s an attitude of not wanting to give up, there’s a strong will to fight and survive,” said Kellough.

Children and grandchildren of survivors can also struggle to cope with their loved ones’ terminal illness, said Rudansky.

He said such people tell the hospice staff, “’My grandfather, my father survived Auschwitz. You can’t tell me they can’t survive this!’ They have great difficulty in wrapping their heads around this is different — this is nature.”

That difficulty can be compounded by the fact that children of survivors may not have had much contact with death in their lives, said Rabbi David Rose, a hospice chaplain with the Jewish Social Service Agency in Rockville, Maryland.

Because so many of their family members were wiped out in the Holocaust, children of survivors may be less likely to have experienced the death of a grandparent or aunt or uncle.

“That’s one of the benefits of hospice. We work with them and their families to help them accept their diagnosis,” said Kellough.

Hospice offers families pre-bereavement counseling, 13-months of aftercare and access to preferred clergy.

Special sensitivity is paid to spouses who are also survivors.

“Survivor couples, particularly if they met before the war or just after the war are generally exceptionally protective of each other,” said Rose. “A few different couples come to mind – every time I visited, the partner was sitting right next to their spouse, holding hands the whole visit.”

Freedman underscored that chaplains are trained not to impose their religious ideas on families, but rather to listen to the patient and family’s wishes.

“I tell the people I train that if you’re doing more [than] 30 percent [of the] talking in the early stages of the relationship, then you’re doing it wrong,” said Freedman.

“Seventy percent of communication is coming from your ears, your eyes, your smile — not your talking. Rabbis tend to be loquacious, we’re talkative,” he said. “But when I’m with a family, I am an open book for them to write on.”

Though the work is emotionally demanding, Freedman said, “Helping people through natural death and dying is one of the most rewarding things people can do.”

 
Complete Article HERE!

Feather Death Crowns: Appalachian Omens of Death

In Appalachian culture, a bizarre phenomenon of feather crowns found in the pillows of sick people became known as an omen of death.

Vintage feather death crown photo by Lori Kimball
Feather death crown dating somewhere between the 1800s and the 1930s.

By J. Nathan Couch

Feather pillows are about as rare the Loch Ness Monster, but once upon a time they were as common as could be.

Long ago, the people of Appalachia began to notice a peculiar phenomenon: odd crownlike masses in the pillows of the seriously ill or recently deceased.

These objects became known as Death Crowns (or less-commonly, angel crowns). Death Crowns are usually elaborate, interlocking designs that resemble a disc or crown. The quills always point inward, and though rare, are only found in the feather pillows of the seriously ill or recently deceased.

Because of the isolated, rural nature of the area, the phenomenon appears to be unique to Appalachia, or locations where some of these mountain folk migrated, such as Missouri, Indiana, and Ohio. But it’s almost exclusively a lost-belief now that most people have switched out their feather pillows for comfort foam or synthetic fibers.

I was fortunate enough to overhear a death crown story in my youth, otherwise I’d likely be unaware such a concept ever existed. My family has lived in Hall County, Georgia for generations, just miles from the foothills of the Blue Ridge Mountains.

My great aunt paid us a visit when I was maybe 5 years old. She started talking about the recent death of her elderly father. He’d been killed while walking around a bus he’d just exited. A car sped by without caution, striking the old man. She was elected the sorrowful chore of sorting through her father’s belongings. As she lifted her father’s ancient feather pillow she felt something solid inside. She started to throw the pillow away, but something compelled her to open it up. She reached inside and probed with her fingers in search of what she had felt. To her astonishment, she pulled out an intricately woven wreath of feathers, roughly the size of a bird’s nest. She took this has a sign her father had gone to heaven.

After several minutes of convincing, she persuaded me to go play. After a while, I forgot about the whole thing—until bed of course. I recall squeezing and kneading my pillow in search of anything that might remotely feel like a “death wreath.” I didn’t. Finally, I fell asleep.

A vintage death crown with post-mortem photo and funeral card
Vintage death crown in a bell jar with post-mortem photo and funeral card.

These odd formations are usually interpreted as a heavenly sign, but skeptics believe that the movements of a dying person—tossing and turning combined with fever sweats–could cause these objects to take form.

If you are one of the few that still sleeps on feather pillow, do not lose all hope if you find a Death Crown in your pillow tonight. One old wives’ tale claims that if you break these wreaths up you could prevent the death of the person the pillow belongs to.

A collection of these oddities can be found at the Museum of Appalachia in Clinton, Tennessee.

Complete Article HERE!

Hospice veterinarian writes how dogs helped her, her mother through challenges of life, death

By SUE MANNING

Dr. Jessica Vogelsang, a hospice veterinarian for Paws Into Grace and the author of All Dogs Go To Kevin: Everything Three Dogs Taught Me, poses for a photo with Brody, her golden retriever Tuesday, July 28, 2015, in San Diego. Dogs provide comfort not just in death, but in other difficult times, whether it’s depression, job loss or a move across country. Dogs know when people are dying or grieving through body language cues, smells only they can detect and other ways not yet known, experts say.

For those who are dying, it’s clear why all dogs go to heaven.

They provide comfort not just in death, but in other difficult times, whether it’s depression, job loss or a move across country. Dogs know when people are dying or grieving through body language cues, smells only they can detect and other ways not yet known, experts say.

As a hospice veterinarian, Jessica Vogelsang knows how much “being there” can mean to struggling people or pets. She’s director of Paws Into Grace in Southern California, a group of vets who provide end-of-life care and euthanasia for pets at home.

The San Diego vet finished her first book, “All Dogs Go to Kevin: Everything Three Dogs Taught Me (That I Didn’t Learn in Veterinary School),” just before learning her mom, Patricia Marzec, had an inoperable brain tumor. The title of the memoir published last month refers to what Vogelsang’s toddler heard when he was told all dogs go to heaven.

Her parents moved in so Marzec could enjoy her last months with family, and Vogelsang’s golden retriever, Brody, picked up on the changes. He always jumped on her parents but stopped when they arrived in April.

“He knew Mom was sick. He was with her 24-7,” Vogelsang said. “He was trying not to be too obvious, but Dad was on one side and he was on the other.”

Brody would lay by Marzec’s feet or rest his head on her lap when he sensed she was sad. He wedged in next to her when hospice workers came by, ignoring her shaking hand as she patted his head, Vogelsang said.

“He is still my dog, but he knew when they came they needed him more than I did,” she said.

Dogs know to comfort people by sniffing out some cancers, such as on the breath of a lung cancer patient, said Dr. Bonnie Beaver, professor at Texas A&M University’s College of Veterinary Medicine and executive director of the American College of Veterinary Behaviorists.

But most often, it’s about body language.

“They recognize fragile, slumped over, not moving as well,” Beaver said. “That’s how they read each other. … They are great at it, and we are not.”

Some rest homes and hospices that have live-in dogs to comfort patients even use a dog’s behavior — such as who the animal chooses to sleep with — as a sign to tell relatives to come say their goodbyes.

“A lot of resident dogs know those people and know something is different, whether the smell changes or they are moving less,” Beaver said.

Dogs also can help those dealing with other challenges.

In the book, Vogelsang introduces pets that got her through some life changes. As a little girl, her Lhasa Apso named Taffy helped her adjust to an unwanted move from New England to California.

Just after the birth of her first child, her golden retriever Emmett wouldn’t leave her alone as she struggled with postpartum depression and a new career as a veterinarian. He gave her love, as well as looks that led to some soul-searching to get the help she needed, Vogelsang said.

Later, an older Labrador retriever named Kekoa taught her to let go of unrealistic expectations as she balanced career and motherhood. When the dog got cancer, Vogelsang didn’t push endless procedures and medications, because it wasn’t right for Kekoa. That led her into the hospice-care field.

After Vogelsang’s mother moved in, the family spent two months watching movies, eating cookies and watching butterflies flit across the yard. Pat Marzec even read her daughter’s book, giving her approval.

She died June 3, about a month before it went to print.

“Those last two months we had were just an incredible time,” Vogelsang said. “Death is just a moment. Life is everything else leading up to it.”

Complete Article HERE!

Island resident one of few to choose death with dignity

by SUSAN MCCABE

These days it’s common to openly discuss topics that past generations would have considered rude, such as sex, money, politics and religion. Death on the other hand, particularly one’s own, often remains a conversational taboo for many, though it’s probably one of the most important discussions to be had with those closest to us.

Greg Smith
Greg Smith

In this state, some people are taking that final topical frontier out of the humidor with death cafes and advanced directives. Some also are taking action with Compassion & Choices, the organization now working with residents in Washington, Vermont and Oregon who choose physician assisted suicide (PAS) when they are diagnosed with fewer than six months to live and no reprieve in sight. Former Washington Governor Booth Gardner led the voter initiative that legalized PAS in this state in 2008, as he faced his own demise from Parkinson’s disease.

Only a small number of people in Washington have taken advantage of the law since its passage. One of them, islander Greg Smith, followed through on his choice on July 27, peacefully surrounded by loved ones. Smith was a long-time advocate of death with dignity and, in an effort to enlighten others, he recorded a conversation with his friend, Lin Noah, on a Voice of Vashon episode of Island Crossroads about two weeks before his final going away party.

Smith was candid in telling the story of his battle with lung cancer, which returned “with a vengeance” two years ago. In May of this year, his doctors told him there was nothing more they could do and that he had two to six months to live. Smith said his decision to take his own life had germinated well before that — at his initial diagnosis.

“I’d seen friends and family members leave this mortal coil with the disease,” he explained, “and realized that was not the end I wanted for myself.”

To offer a chance for family and friends to say goodbye, Smith organized a party for the night before he was to drink his final cocktail.

To assure that key friends and family could attend, “I had to schedule my suicide around other people’s vacations,” he said laughing. He added that he chose a date just three months after his final diagnosis because he didn’t want his sons to go through the final stages of lung cancer with him.

Smith’s sons, ages 31 and 28, spent considerable time working with him to accept his early demise – Smith was only 61 – and respect his wishes for a peaceful passage. Smith called his choice an opportunity to “stand up with dignity, face cancer and embrace my sons one last time,” rather than dwindle from life in small and excruciating increments.

Snubbing his nose at cancer, Smith said he chose PAS to take control of his life away from the disease and end it on his own terms. Smith had written on a national PAS blog for some time, urging people in other states to have the freedom to choose. One reader took his impassioned diary to the American Medical Association’s (AMA) national convention. The follow-up report was that the AMA’s ethics committee reviewed Smith’s diary with fresh eyes, generating hope that the association might reconsider their opposition to PAS.

To those who would wonder if he might change his mind, Smith said he didn’t want to continue “playing roulette” with the end of his life and that he was ready to say goodbye. He added that with the awareness of death’s imminence, he felt he had used his time well, deepening important relationships.

Some would say doctors have been behind the curve in the move toward choices at the end of life. Naturopath Brad Lichtenstein leads so-called death cafes in Seattle, where people gather over coffee to address the inevitable, honestly and in a safe environment. He has stated that while most physicians eschew heroic measures at the end of their own lives in favor of dying quietly at home, they often implement every available life-prolonging tool for their patients.

“For a physician, when a patient dies, they’ve failed,” he explained.

Statistics show that more money is spent in the last months of life on extra measures that often will not prolong life at all. But, in the absence of a living will or advance directives, doctors will do everything possible to keep a patient technically alive.

Lichtenstein’s death cafes, the growth in the number of palliative care physicians and the entry of hospice care into the mainstream all herald changes in the end-of-life field. Soon, islanders will have access to a program to assist in the process of identifying preferences and creating advance directives for end of life before it is imminent. Called Honoring Choices, it is based on a model that originated in Lacrosse, Wisconsin, and will be offered by nurse practitioner Wendy Noble, and Carol Spangler, who has a graduate degree in public health. The two will offer facilitation services to families free of charge.

Noble and Spangler will host a presentation on Thursday by Bernard “Bud” Hammes, Ph.D., the medical ethicist who developed and directs the Wisconsin program (Respecting Choices). Hammes, an international leader in the field of end of life issues and advance care planning, has been featured on NPR, ABC’s Good Morning America, CBS Sunday Morning, NBC Rock Center and, most recently, on the PBS program, “Caring for Mom and Dad.”

He will appear with, among others, representatives from Honoring Choices Pacific Northwest, the Snohomish County Health Leadership Coalition and the Whatcom Alliance for Health Advancement, two organizations that have successfully implemented the program in their communities.

The presentation, according to Noble and Spangler, will provide specifics on what advance care planning means, why it’s important and what’s happening in the state to help people develop advance care plans.

What the two say they hope to do on Vashon is two-tiered. Their first step is to train others in the process of facilitating Honoring Choices.

“With a trained team,” said Noble, “we’ll begin small group conversations about advance directives and provide appropriate documents and instructions for completing and filing those directives.”

And when invited, they’ll meet with individuals and their families to help clarify their wishes for end of life health care.

As Spangler noted, “Determining and sharing end of life choices is a process. It’s a difficult discussion to start with one’s family.”

She and Noble say they are committed to helping Island residents start those discussions and share their decisions.

Professionals in the “death trade,” as it’s often referred to, agree that discussions of death and dying are really about living. With the implementation of this program, it appears that Vashon will soon be a place where people are ready to lead both the exploration and the conversation.

Complete Article HERE!