FEATURE
Quality of Life at the End of Life: A Full Spectrum of Care
An article by Robin Swift, EOLONM Administrative Director
Advance health care planning offers the best avenue for New Mexicans to ensure that their wishes for care at the end of their lives are documented and honored. Many New Mexicans learn about their end-of-life options through the work of EOLONM’s Public Outreach and Education (POE) volunteers. At community presentations and tabling events, they provide general information about the spectrum of options in preparing for one’s end of life.
Robin Swift, MPH
The inquiries that come to the EOLONM warmline (505-393-1321) or the general email inbox (info@endoflifeoptionsnm.org) address a full range of issues. Our warmline dispatcher, Elaine Clanon, answers client education questions related to legal requirements, advance health care planning provisions, or other community resources that are available to help with informed decision-making. Many calls and emails address the specific requirements of the New Mexico EOLO Act, most often residency requirements and whether their illness is terminal in the eyes of the law.
Access to information leads to better planning, better planning improves access to care, and better care supports clients’ rights to have their wishes honored as best they can be.
Many callers want to ensure that their advance care planning documents are complete and comprehensive. We caution that advance directive wishes to use MAID may not be honored if they develop any issues with their mental capacity to make decisions, as the law requires. We review alternatives to MAID with clients who seek them, and we refer callers to resources that help them have conversations with their families and providers about their end-of-life wishes. Clinicians and social workers also call with specific questions related to MAID, medication assistance and other resources.
Client Support Volunteers (CSV)
Client support volunteers (CSVs) vastly expand the spectrum of care that EOLONM provides. This work calls on their skills as thoughtful, compassionate listeners, knowledgeable teachers, and gentle advocates. After extensive training and individual mentoring, CSVs can provide individual support to clients seeking hospices, palliative care or prescribers who support MAID. CSVs listen to family concerns, they explain the range of options including the MAID ingestion process in detail, they teach what is involved in voluntarily stopping eating and drinking (VSED), and they gently remind clients of the necessity for funeral home arrangements made in advance. With the client’s permission they check in with caregivers as well, ensuring that they understand the client’s choices, and have access to grief support after death. More experienced CSVs are always available to help solve problems that arise in client support work. The CSVs and warmline dispatcher meet monthly to share their experiences of this work, to discuss its impact and to receive informed guidance.
Many EOLONM CSVs are certified as end-of-life doulas – companions willing to visit and be with people at the end of their lives. In some instances, pairs of EOLONM doulas have attended MAID ingestions when the prescriber cannot be there. Such volunteers receive additional training in what to expect, the limits of their role, and how to process those experiences.