Don’t remain silent about end-of-life care

What gives meaning to my life?

From our childhood through our retirement, we live our lives as a response to this question. Our decisions about education, careers, finances, home, and relationships are all demonstrations of our personal priorities and values.

Too often, however, our values and priorities may not be reflected in health care we receive — particularly at the end of life.

When confronted with a life-threatening diagnosis, too often we are emotionally, cognitively and spiritually unprepared. Without conversations and an advance-care plan, our healthcare team and even our families may not know our preferences, especially if we are unable to communicate.

And too often, the default path of medical care does not reflect our individual values.

In Snohomish County, some 4,500 people turn 65 each year, and a similar number die. If we’re like other Americans, 90 percent of us have heard about a living will, and 71 percent have thought about our medical care preferences at end of life. But only 29 percent have translated their desires into a living will.

An Advance Care Planning initiative is underway in our county to change that. It’s part of a larger set of initiatives sponsored by the Snohomish County Health Leadership Coalition — leaders in education, health care, business, nonprofits, public health, human services and the faith community — aiming together to improve the health and prosperity of our community through better health and health-care value.

A day of action is planned for April 16 — National Healthcare Decisions Day. It is a campaign to inspire, educate and empower the public, as well as medical providers, about the importance of planning in advance for the medical care you want, and do not want, when faced with life-threatening illness.

Leaders in our medical community are among the first to say that advance care planning is important.

At The Everett Clinic, Dr. Elizabeth Marshall and her team have been promoting end-of-life conversations for three years through education of providers, staff and patients. The classes have changed staff comfort levels with talking about this difficult topic — ensuring that patients’ values and wishes are addressed.

Cathe Clapp, a nursing director at Swedish Hospital in Edmonds, says they began offering free assistance for the public after seeing firsthand the anguish experienced by patients and families who arrive in the ER without having documented their preferences in advance.

At Providence Regional Medical Center in Everett, which is running advance-directive classes for staff and doctors so they can have more introspective conversations with patients and families, Chief Medical Officer Joanne Roberts, MD, envisions a day when every patient’s treatment plan is built on a simple question: ‘How do you want to live the rest of your life?’

This is too important to be left to the health-care system alone. Now a growing community coalition — local senior centers, the faith community, service organizations, the YMCA of Snohomish County and others — is working together to ensure Snohomish County residents are equipped to get the care in line with our personal values when facing life-threatening illness or events.

A series of events and community conversations are scheduled around the county for April 16 and in days and weeks to come. The day begins with an advance care planning education session at Swedish Medical Center-Edmonds; the day ends with a community event at Trinity Lutheran in Lynnwood bringing together an array of community resource organizations. Next, the YMCA is offering future free classes open to the public in Marysville and Mukilteo, and more events and course options are occurring countywide (more information at

You are the only person who can decide what is right for you. Organizations across Snohomish County are coming together to provide the process for personal discovery and learning. Now is the time to start the thoughtful decision-making process. Everyone is invited to participate regardless of generation or health to ensure that living well is something we are intentional about throughout our years. We invite you to engage with us and take action.

Jim Steinruck and Rev. Eileen Hanson are steering committee members of the Snohomish County Health Leadership Coalition, and co-sponsors of the coalition’s palliative care/advance care planning initiative. Steinruck is CEO of Senior Services of Snohomish County. Hanson is pastor of Trinity Lutheran Church. For more information, see

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