White Bird Mutual Aid

End of Life Counseling with Amy May

November 09, 2022 Hana Francis Season 1 Episode 6
White Bird Mutual Aid
End of Life Counseling with Amy May
Show Notes Transcript

Amy May, the founder of the End-Of-Life Counseling department at White Bird Clinic, speaks about her life working with death, and the importance of talking about death  in our lives and with loved ones.

To find out more about White Bird Clinic, visit whitebirdclinic.org.

Amy May:

It seems to me that with, with the advancement of Western medicine, that we started to feel really good about being able to keep people alive. And in a lot of ways, that's a real gift, right? I mean, our life expectancy has increased substantially over I don't know, the past 100, 200 years. And, and in a lot of cases, that's a real benefit. But I think along with that advancement of, of life sustaining practices, you know, whatever that looks like, whether it's vaccines, or, or life sustaining surgeries, or, you know, whatever it's, it feels like, like all of Western medicine basically. But I think with that, somehow build this idea that that death is a failure. It's a failure of Western medicine to keep people alive. And when we lost somewhere along the way... the knowing that death is a really natural part of living. It's like the most natural I mean, it's something that we will all succumb, to 100% of us will.

Hana Francis:

Thanks for tuning in to White Bird Mutual Aid on 97.3 KEPW. I'm Hana Francis. Here we talk about white bird clinics, past, present and future. I interview white bird staff, volunteers and clients who share some of the experiences as well as some of the knowledge that they have gathered, while being a part of this community oriented nonprofit. A little while ago, I had the honor of speaking with one of White Bird Clinic's counselors, and the founder of the End-of-Life Program, and just a profoundly beautiful and wise human being, Amy May. For the next hour, I get to share that conversation with you.

Amy May:

Yeah, my name is Amy May, and my job title within White bird. I'm a counselor in the counseling department. So I'm an end of life counselor and death doula. And I'm a licensed clinical social worker. So I guess that's my credentials. And my pronouns are she/hers.

Hana Francis:

Today, we're talking about death. I know this can be a sensitive subject. There's a lot of taboo and a lot of emotions surrounding the topic. And yet, death can be a beautiful part of life. Even if this episode makes you feel a little uncomfortable, all I hope is that it will bring up some conversation and thoughts and maybe make death feel a little less scary. It is after all, like Amy May said, something that 100% of us will succumb to I'm certainly glad to know that people are talking about death. And that we can to the end of life program at whitebread clinic was started only a few years ago in the counseling department in 2018. In this episode, we speak about what Amy's job entails, how the program was started and some social stigmas around death. The specific services that Amy May provides differ with each client. The two main areas that she provides support in are emotional and physical support for folks who are dying. And for people whose loved ones are dying or have died. She provides these services no matter the client's socio economic status. Whether that is creating an Advanced Directive, carrying out funeral plans or helping create a celebration of life, Amy may does this with a special kind of care and attention that I have a hard time finding anywhere else.

Amy May:

Number one, my goal is to emotionally support clients in the dying process. So and that's like through counselling service. So so we're talking about the fears or anxieties or sadness, the grief of what that means working through the emotional side of it. And then the spiritual aspects of what their beliefs might be for what's happening now or what happens after one dies. And then there's the logistical side of kind of case management work of coordinating with other agencies, either the hospice agency the client is working with or if they're not, through other service agencies, if they're seeing other mental health workers, or if they're in the hospital, and working with social workers, they're at the hospital to help them support, get the support they need. So that's just kind of a broad overview. So it's counseling services, you know, kind of the emotional spiritual exploration of where they're at. And, and then the logistical needs, which are vast. That can be like I said, coordinating with hospice services to either, you know, it appears that they need more, I don't know more help in their home, or if they are trying to figure out what sort of interment they're interested in, if they're trying to square away new cremation plans, or if they're utilizing Death with Dignity, helping them navigate that process, and coordinating with end of life choices Oregon, or elk, or is is the acronym. I've had clients who read clients who really struggle in staying housed sometimes, either because they are challenged with managing their finances in a way to, you know, be paying their rent on time or, or just adhering to behavioral expectations of facilities that they're in. I've had a client I worked with who was actually terminated from their hospice services because of substance use, that they were continuing to engage in. So then I had to try to advocate for him on another number of levels where his hospice probably would have if if they had been engaged. I've helped planned in like death ceremonies for folks who utilize Death with Dignity or medical aid and dying, and create what that what the individual wants that to look like, what that day will look like how it will feel who will be around. So yeah, but I'm sure that there are some gaping holes there things like didn't include that. That's part of it.

Hana Francis:

I was curious what led Amy to pursue this career, and how she started the end of life program.

Amy May:

I'll just start at the beginning. My mom died in 2011. And it was, you know, a life changing, devastating experience. A few years later, I was, of course, still coping with it. And I went back to school. Just as I was trying to finish up my degree, I was 30, something years old, and just wanting to wanting to do something and took a class on death and dying. And it was during that class that I realized, oh, my gosh, this is what I need to do, is I want to work with people who have had similar experiences from the one that I had, that was really difficult. I really struggled with making sense of it. I guess a little more background than that is I was born and raised in the south and Arkansas. My family all holds very strong Christian faith and values. But I diverge from that on my own spiritual path. And so when mom died, it was really evident that my family had some comfort and help coping because of their beliefs and their faith. And I didn't have that in the same way. I mean, I thought that I understood something about death and dying are my beliefs around it, but I I was really forced to confront it when when she died. And so then fast forward a couple of years Just down the road, and I'm learning about folks who are are in the field of death and dying. And and realize, Oh my gosh, this is what I want to do is just to be there with folks who have all of these questions who have all of these feelings, who don't necessarily have the support that they need to help them either cope with the death of someone, but even more so start to understand the process of death and dying, and to support an individual in their family or loved ones. In that process,

Hana Francis:

Amy may found white bird through an MSW or a medical social worker internship while getting her degree.

Amy May:

So I finished my bachelor's degree, I went on to get my MSW, my mentor, who was my teacher in that class suggested that I go into social work because it would make me more employable in the field of hospice and end of life. And so that's the route that I took. And I ended up a white bird doing my MSW internship in 2000s, January 2017. And it wasn't, it wasn't necessarily the kind of agency that I was thinking I would work for, because I was very specific to wanting to work in end of life. And, and, and wiper wasn't doing that. But it was where I was able to get an internship. And I'm grateful that I did, because it really opened my mind and my understanding of so many folks who are facing different sorts of barriers and challenges, who are part of marginalized communities for for whatever reason, whether it's for race or socio economic, or you wherever they, you know, substance use wherever they find themselves aren't able to access end of life care. And the same way the other privileged folks are.

Hana Francis:

Hospice services are extremely valuable. But there's a remaining need for care for folks who do not have access to certain privileges. One of the unique advantages of white bird is the ability to see a need in the community and organize to try to provide it through this process of striving to provide for people in need, the end of life program was founded.

Amy May:

So I ended up completing all of my internships through my burden fortunate because we have such a wide array of services that we offer that I did a semester in the crisis office, I did a semester in cahoots, I did a semester with rock medicine, and then my last semester in counseling. And through through those years of of working in those departments I was hired on in the crisis department as a crisis worker, I was hired as a huge crisis worker and I still hold the shift. I still work as a CAHOOTS crisis worker one day a week.

Hana Francis:

In case you're unclear, CAHOOTS is the mobile crisis intervention unit of whiteboard clinic, in which crisis worker and a medic are dispatched by the ambulatory line in Eugene and Springfield metropolitan areas.

Amy May:

It was through CAHOOTS, that the end of life counseling program and the seed was planted. I met a kahootz client on the street one day, he actually approached us in the van and said he was he was expressing gratitude for the support he had gotten from the kahootz team through his years of living on the street. And he, he shared that he had recently been housed because he was on hospice and received a terminal diagnosis. And of course, then my ears perked up. I was like, Oh, what is that like? And, you know, where are you living? Do you feel comfortable and just seeing was asking questions and, and he's, he shared the know, he was really scared and had a lot of anxiety over what this meant, what the rest of his life was going to look like. And he didn't feel like he had the support that he needed. So I had him sign a release of information that day and asked him if it was okay that I contact his hospice social worker to see if there were other ways that we could help provide support because he trusted wirebird He had a long relationship with staff. And he said, Absolutely, yeah, that would be great. So I called the social worker and she said, Oh, heavens, yes, that would be fantastic because she felt it was beyond her scope of practice to read. The understand and be able to meet him where he was at with the barriers and the needs that he had from his years of being unhealthy from his years of substance use all of the different challenges that that was bringing to the table at end of life. So she was really excited for us to get involved and helping support him. So then that left me in this place of like, well, how do I do this? What is the right platform for which to engage in surfaces, but this guy because it's not, it's not Cahoots work, it's not crisis on the streets. This is something different. And so my supervisor at the time, Kay suggested going to the counseling department and talking to them, they knew me I had done my last internship with them. And so I did I, I met with them and said, Hey, I think that I would really like to start doing end of life counseling, in people's homes, meeting them where they're at, and got 100% support.

Hana Francis:

Amy May saw gap in our society and is trying to address it with her work. And I admire her so much for doing what she's doing. I don't know what else to say about that. I just wanted to say, she's amazing.

Amy May:

And so that's where it started. And through that hospice social worker that I contacted, I got referrals, I was starting to meet other hospice workers, I got involved with death with dignity and work really closely with the end of life choices Oregon organization and their volunteers.

Hana Francis:

So Death with Dignity is a legislation that was passed in Oregon in the 90s. legalizing the use of a doctor prescribed and self administered lethal medication. This is only available for people who receive a six month terminal diagnosis from their doctor. In other words, the Death with Dignity Act is to allow people with terminal illness to control the way in which they die. I asked Amy May to talk a little bit more about death with dignity.

Amy May:

Oregon was the first state to legalize what they initially call like Doctor assisted suicide, which I think is a really inaccurate description of it. So for someone to access, medical aid and dying, they must be terminal, they must have received a six month terminal diagnosis from their doctor. And, and while they don't necessarily have to be engaged in hospice, that's just can be part of it, but they don't have to be. So in order to access the medication, there have to be two doctors who have gone through the patient's records, and agree that yes, this patient is dying, imminently dying, meaning and you know, six months or less, and then, and then they sign off on writing the prescription for the medication. That is that would in their life. When someone chooses, or someone both thinks that they want to use medical aid and dying, they have to make a verbal request to the prescribing doctor. A lot of folks doctors either aren't comfortable doing that, or they're not able to because of the policies of the agency or the clinic under which they work, they're not able to write those prescriptions. So often, the clients that I've worked with have utilized the the pro bono doctors that work with end of life choices, or again, they're their volunteer doctors, with decades and decades of experience, and they work closely with the individual looking through their record. So anyway, they the individual would make that verbal request that would be documented in the record. And then two weeks later, they make a second verbal request. And they have to be they have to be able to articulate that articulate that they understand that this medication would end their life. And then once that prescription, let's see the two doctors have to sign off on it. And then once the prescription is sent in, it takes a little time to be processed up in Portland before the individual gets the medication. So when they take the medication they have to be able to administer it themselves. They have to be able to articulate the that they understand what the medication and is going to do and then they have to be able to take it themselves as a process and mixing it, you have to take anti nausea medication a certain number of hours beforehand. You can't eat certain things for the 24 hours before so that the medication will, you know, have maximum absorption. And so yeah, it's a bit of a process, the idea behind it, and why it's important that it's not called Doctor assisted suicide, or even like medical suicide, is because these folks are imminently dying. So someone who is, is either attempting or is considering or succeeding at suicide as someone who is not otherwise dying, whose life whose whose life would continue if it wasn't for that choice to end their life. That's not the case with terminal patients. So the reason that are one of the main reasons that this was implemented was to again, bring back bring back some autonomy and some choice and empower an individual to die in a peaceful way of their choosing. There's a lot of different diseases, that illnesses that progress in really horrendous ways that cause an immense amount of suffering, even with the best pain management that's out there. And so it's not right for everyone. It's a totally individual decision. And there are lots of feelings and lots of beliefs around it. And I definitely want to honor all of those, all of those differing feelings and beliefs around. But I have personally witnessed folks who were really suffering who utilized it with in the midst of this really loving, supportive environment, who were able to give the gift to themselves have a peaceful death. And I think that that is not something no matter what my beliefs are, that is not a choice that I, I feel entitled to take away from anybody. I want to really highlight that there. It's a very specific protocol, because I do get calls from clients who are like, I'm suffering and I want to utilize this process, but don't really understand all of the specifics around it. So yeah, hopefully that helps.

Hana Francis:

End of Life Choices Oregon, or ELCOR, the organization that Amy mentioned, is a nonprofit that is dedicated to helping clients through processes, such as death with dignity. To find out more, you can go to EOLCoregon.org.

Amy May:

End of Life, I mean, the dying process is, I believe, a sacred rite of passage that, at least in our recent history, has not been granted the honor and the respect and the reverence that it deserves. And we tend to have, you know, some, some ritual after someone dies, but which I think is lovely, but the bringing that in, to pre death where the individual can participate in it, and, and really, with a lot of intention, create the depth that they want, and how just how they want it all to look, I think it's so important to bring that back. I mean, it hasn't been that long since we were doing that. And some cultures still, you know, have have continued to do that, despite, like Western you know, like the medicalization of death and dying. And I just so that I feel a lot of passion and inspiration to try to bring that back to the individual is empowering them to not just death, but to have the life up until death that they desire.

Hana Francis:

This view of looking at death, and wanting to celebrate it as a rite of passage struck me as a very powerful and unique viewpoint. But why don't more of us see death this way? What parts of our culture have made us look at it in this fearful and denialists mindset? Our culture obviously is such a stigma around talking about death and, like acknowledging it. And I mean, it's a such a deeply ingrained and huge issue that it's not really easy to talk about all at once. But I wonder if you could talk a little bit about maybe why you think that is how our culture has shaped that fear and stigma? Because, like you said, it's not in all cultures.

Amy May:

Mm hmm. A big part of it, I think is the medicalization of the process. Folks were dying at home up until not that long ago, and and their bodies would lie there in their homes for their family to attend to and care for until they were interred. Yeah, it wasn't that long ago. And, and so it seems like maybe there was this there was the shift. The like, let's, let's keep people living a little longer and to like, we can't let them die at any cost. To weird now we have like this, which can sometimes. So yeah, I think that that has that has had a huge impact on our Denial of Death within our predominant culture. There's a lot of people talking about this right now, especially the the hospice. The hospice field has really gained a lot of speed in the last three decades for decades. And people are becoming more aware of what what our choices are there.

Hana Francis:

I have so much gratitude for Amy May, and her time and presence and for the amazing work that she does. If you have any questions for Amy May about the end of life services or any of the things that we talked about today. You can email me at whitebirdmutualaid@gmail.com or you can email Amy at amymay@whitebirdclinic.org. You can also call the clinic number at 541-342-8255. For more information on white bird counseling services, you can go to whitebirdclinic.org/counseling on 97.3 KEPW Thank you for listening. I'm Hana Francis.