May 22,, 2025 -  Tom Paradiso,  EOLCCA, (End of Life Choices California)

His talk covered advanced care planning that aligns with values; there is a values worksheet as a first step with which families might list preferences for advance directives. Items included just how do you define “quality of life” including mental alertness, “comfort care” like antibiotics, stimulants or other drugs, wishes around spiritual care, and the option of a trial period. Its “My Particular Wishes” chart detailed wishes for specific therapies including treatments such as electroshock or artificial nutrition or hydration, depending on doctors’ input. It also touched on what a patient might choose for specific therapies, a health care agent (formerly Power of Attorney), wishes around organ donation, nomination of a conservator, and health care options with two signatures. 

EOLCCA also offers bereavement support and includes factors such as family division, stigma, ethical aspects and uncertainty around a loved one’s choices, and a support group structure that provides a safe space where participants can share experiences. The organization gave a nod to volunteers in April as Volunteer Appreciation Month.

EOLCCA also covers personalized hospice and palliative options from aggressive treatment to comfort care. An aim is to demystify the process, allowing for health care autonomy from initial conversation to documentation. 

Advance Care Planning was emphasized as important also because it enabled participants to make plans for their future health care, and is applicable to adults in all stages of life, as it is shown to reduce stress around the making of those decisions. 

Advance Directives could also include a living will, durable power of attorney and health proxy, emphasizing the importance of a previously written health record or wishes. Advance notifications also include physician orders for life-sustaining treatment, dementia  provisions, DNR (Do Not Resuscitate) or out-of-hospital DNR.

The papers to which Tom had access included steps to creating an advance care plan: reflecting on values, selecting a health care agent, communicating and documenting your wishes.  They also touched on MAiD (or Medical Aid in Dying) eligibility. It was advised to regularly review this. Sharing stories with EOLCCA was also emphasized. EOLCCA emphasized having conversations with loved ones about care and/or involving religious and spiritual leaders – even for those young and healthy.

Further reading suggestions were also included.