What are your plans for Advance Care Planning/Healthcare Decisions Day?

National Advance Care Planning Day/National Healthcare Decisions Day are on April 16

We’re curious about what types of plans have been made for April 16th – National Advance Care Planning Day / National Healthcare Decisions Day. Leave us a comment to tell us what is (or isn’t) happening in your area.

You’re not alone if plans have not yet been made. And it’s not too late to get involved. Anyone can participate in small and big ways – there’s something for everyone. You can begin by helping spread the word!

Resources in Canada

Resources in the United States

In the US, there are resources available for National Healthcare Decisions Day on April 16. In fact, this will be a week-long campaign, from April 16 to April 22, to help people understand the value of advance healthcare planning.

Tell us what your plans are – or tell us about the barriers to Advance Care Planning/National Healthcare Decisions Day.

Check back and see what others are doing as well.


Thanks to Michelle and Reena for this posting….
Earlier this year, we (Michelle and Reena) both spent time actively being with the fact that we’re going to die and we don’t know when; could be tomorrow, could be next week, or 37 years from now. It changed our lives.
We each wrote a Heart Will to be read at our end-of-life rituals, and Love Letters to our respective school-aged daughters to have when we die. The impact on us continues to be profound. Reena finds herself gushing with acknowledgements and expressions of gratitude to people around her and about everyday events, not something she ever did with abundance before. As a result she finds life to be so much brighter and lighter!
When writing her love letter to her daughter, Michelle asked herself, “What have I learned in my 48 years that will help this 10-year-old girl navigate her life, no matter what age she is when I die?” This process of letter writing helped Michelle uncover and crystallize one of her core truths; a truth that now calls her to account every day:
“I am my own best friend and my own worst enemy. It’s my relationship with myself not with anyone else that needs attention, tenderness and care.”
We launched WILLOW last spring with the radical goal of transforming the often-fragmented process of what is usually called “advanced planning” into a rich opportunity for personal growth and transformation. We want people to use that opportunity of getting clear and communicating their pragmatic and prosaic wishes about all matters ‘end of life’ — health and personal care, financial and legal matters, deathcare and funerals, legacy and remembering — to make a difference to the richness of their lives now no matter their age or state of health.
We’re all going to die, and we don’t know when. If you’ve experienced the death of someone close to you, then alongside your sorrow, or perhaps even your relief, you may have felt a force to renew or change something in your life. People in their dying days often speak of experiencing enormous growth and transformation while contemplating death. If death can provide this, so too can the conscious contemplation of your mortality. Let’s make our mortality work for us.
Your mortality is an opportunity in disguise.
At WILLOW, our core desire is to inspire personal reflection and action that will touch, move and inspire you, or make you stop and wonder, and perhaps even reconsider. To support you to reflect on your life and create lasting messages for those you love, we designed a weekly workshop series that will inspire you to live fully now.
LOVE LETTERS + HEART WILLS will be offered in Vancouver this WINTER (Jan 26 start) and SPRING (Mar 15 start).
In a thoughtful and dynamic group process we co-facilitate a small group process in which you will:
Uncover the source of your feelings about your inevitable death.
Reflect on your life and how you want to be remembered.
Write a Heart Will and at least one Love Letter to capture your wisdom, wishes and special messages to be shared at or before the time of your death.
“LOVE LETTERS + HEART WILLS was ground-breaking, transformative and essentials reflections for the soul.” – Helena Cynamon
With extensive training in deathcare—Michelle as a funeral director and hospice volunteer and Reena in all aspects of family and community-led deathcare —Reena and Michelle share a passion for using the conversation around death as a pathway to growth and healing for individuals, communities and the planet.

With every cell in our bodies, we believe that contemplating your inevitable and unpredictable death can actually light up and enrich your life now. To dive deeper into this area of personal reflection and discovery, we invite you to:

  • Forward this post to someone you know who loves to explore who and what matters most.
  • Forward this post to someone you know who loves to explore who and what matters most.
Michelle and Reena
Michelle Pante <michelle@willoweol.com>

The Right to Palliative Care

We just attended the Hospice Palliative Care Ontario 2016 Conference in Toronto. Wonderful event with nearly 800 attendees.

Much talk about PAD (Physician Assisted Dying) or MAID (Medical Assistance In Dying). The following day there was an interesting opinion piece in the Globe and Mail by Dr Tom Koch, a gerontologist and ethicist, who provides chronic and palliative consultations. The title of the article, “The next court challenge, the right to better care“.

Koch asks the question, “If the Supreme Court decision enshrines choice as a principle of Canadian justice,  then what choice are we to be offered? If it is between constant pain and an early death, most of us would prefer the latter. Expert palliative care can mitigate physical suffering in, according to experts, perhaps 95% of all cases. But at present, that level of pain control is unavailable to many Canadians. Without its surety, the choice is limited, if not empty, and justice therefore denied because a real full choices is withheld. Similarly, all agree that end stage home care and hospice care can make the last stage of an illness more than bearable. But many Canadians who would choose this, can not, it is not available. And without its insurance, the choices they are offered to care to the end are limited.”

The most important discussion in hospice palliative care today is: How do we integrate palliative care principles, practices and philosophy of care, from time of diagnosis, for people with any life limiting illness, across all care settings?

With the current needs of the dying, and with the anticipation of the increase in number of death annually, it is imperative that we follow the lead of Palliative Care Australia, and recognize that care of the dying person and the family is everybody’s business! And every nurse, every health care worker, every member of the health care team needs to be able to provide, access or refer individuals to services that will address their needs.

In Canada and in the United States, most dying people do NOT receive the services of a specialty hospice and/or palliative care team. The good news is that most dying people do not require the services of a specialty team. However most people who are dying, and their family, can benefit from the integration of palliative principles in the care provided by their general primary care team.

Most dying people can benefit from the principles, practices and philosophy of hospice and palliative care being integrated in care delivered by their primary care providers.

The primary care team may include the nurse and the health care workers on the medical unit, in the emergency department, working in long term care, working in the community, working in the doctor’s office.

This is education that can and should be integrated in core curriculum for all health care workers and nurses (as well as all members of the health care team)!

Nurses and Health Care Workers (AKA PSWs, NAs, HCAs etc) need to know that caring for the dying is part of their work, and they need to develop the competencies to do so.

We have developed our resources for this purpose. And, last month I delivered a webinar, for nurse educators, looking at how they can “Integrate an Educational Approach in Palliative Care“. If you are looking for ideas or inspiration on educating the health care team, then you might want to check out the recording.

On the other hand, if you are a health care worker and want to explore how you can integrate a palliative approach in the setting where you are working, you might be interested in the text and workbook, podcasts and videos.

Canadian Resources  |  American Resources

And finally, if you are a nurse looking for an easy to read, delicious and digestible palliative care resources – the new text, “Essentials of Hospice and Palliative Care: A Practical Resource for Every Nurse” will be available in July 2016!!

Personal reflection: Medical Assistance in Dying

Today Bill C-14 was presented to parliament. big smooth rock in water

Today the Canadian Government introduced legislation to make medical assistance in dying legal. The facts about the proposed legislation can be found here.

People have asked what I think about Medical Assistance in Dying. I have not presented my thoughts openly on this topic, for a number of reasons. Tonight, I will respond to those who have asked, and I will share a few very personal thoughts.

April 14th. My reflection on Medical Assistance in Dying

In an ideal world it would be nice to not have this issue before us. But we do not live in an ideal world.

In an ideal world, people would have access to hospice and palliative care services, holistic person centered care would be available from time of diagnosis through to and following death. But we do not live in an ideal world.

In an ideal world, community would care for one another, people would not be lonely, and needs would be addressed from childhood on, fear would not exist. But we do not live in an ideal world.

In an ideal world, there would be funding to assist community to address sorrows and suffering. But we do not live in an ideal world.

In an ideal world, people would not struggle for air, pain would not saturate a person’s being… but again, we do not live in an ideal world.

Ideal is defined as a standard of perfection or excellence, existing only in the imagination, not real or actual…  And this type of ideal does not exist.

So, for these reasons, I know that there are situations where medical assistance in dying is needed.

I understand that for many people, that this is not about the degree of suffering, but rather the desire to have control over how, when and where people die. I appreciate that as Canadian, North Americans, that autonomy is a most important value. And so, I am satisfied that this is what the Canadian people want.

For me, the lesson that I am forever having to learn, is to let go of control, and to allow life. I think that this may yet be one of my lessons in dying, to let go and let life – and death – occur.

Years ago I heard of a midwife in Australia who commented on the decision that some women were making to choose and plan a cesarean section in advance, preferring the surgery over natural childbirth. The midwife asked, “Have women lost confidence in their ability to birth naturally?” and in reflecting on that comment, I wonder, “Will we… or more importantly, will I have the confidence to die naturally?”

I understand the rationale for this new legislation. I understand the desire to want to choose.

And I will continue to hope that my living and my dying, will afford me the opportunity to go sweetly and naturally into that good night.


PS, another day I will write about the specifics of this legislation… there are a few things that I am especially glad about.

PPS, You are invited to share your thoughts and feelings here. Please be kind and respectful though. I have no space and time for turning this into a debate… the decision to allow Medical Assistance in Dying has been made. We now look ahead to developing and influencing policy to protect the vulnerable, those who want the service, those who don’t, those who want to assist, and those who do not want to be involved in any way. How are we going to do that? And, as evening and night falls around you, what are your thoughts and feelings? What are your concerns as a person and as a professional? What do you worry about? What are you glad about? What process are you using for understanding and grasping this new legislation?

PPPS, I am honoured to have David Wright from the University of Ottawa provide a piece on Medical Assistance in Dying for the new text for nurses that we are working on. He is a gifted writer, and has done some great research on this topic.