“I feel like I moved from one kind of paradise to another,” said Susan Plummer, describing her arrival in Santa Barbara from Mendocino County.
Plummer arrived three years ago, recruited to serve as the very first director of the Alliance for Living and Dying Well, a nonprofit collaboration of leaders and organizations that are committed to ensuring high-quality end-of-life care.
“We have two missions,” Plummer explained from her office in the Riviera Theatre building on Alameda Padre Serra. The “dying well” part of the organization, she said, “is to make sure that we create and sustain a compassionate, seamless continuum of end-of-life health care.”
Collaborators in the alliance’s work include doctors and representatives from Cottage Health System, Hospice of Santa Barbara, Sarah House, Visiting Nurse & Hospice Care, Vista Del Monte, Archstone Foundation, St. Francis Foundation of Santa Barbara and the James S. Bower Foundation, which gave the Alliance for Living and Dying Well its first three-year grant to hire Plummer and solidify the organization’s work.
“We are really a collaboration,” Plummer said. “Our second mission (the “living well” part) is to provide opportunities for the community to become more aware of that reciprocal relationship (between the different groups) and a lot of people involved in midlife care. When someone you love gets a diagnosis, suddenly what really matters moves to the foreground. If someone is confronted with their own mortality it becomes the most meaningful part of the program.”
Plummer, a psychotherapist in private practice for more than 25 years, continued.
“We would like to not wait for that crisis,” she said. “What if we lived every day with that awareness of our mortality so that we can live more fully according to what our own wishes are. ... And we have initiatives around that area.”
One of those initiatives is a program called the Five Wishes Family and Friends Program.
“Five Wishes is one form of an advanced health-care directive,” Plummer explained. “At Cottage Hospital they’ve been tracking the rates of the patients who arrive with a complete advanced health-care directive, whether it’s the Five Wishes or not. It was 4 percent when we came and now it’s 9 percent. We would like to increase that number.”
The Five Wishes encompass instructions for:
» The person I want to make care decisions for me when I can’t
» The kind of medical treatment I want or don’t want
» How comfortable I want to be
» How I want people to treat me
» What I want my loved ones to know
“Every day there are patients and families struggling because they don’t know what their loved one would want,” said Plummer, who was director of a medical hospice in Northern California for eight years and, until recently, also served as board president of the California Hospice Foundation.
There is also research showing that the advanced health-care directives that are most likely to be implemented and honored are those that were developed in the context of conversations with families, which is why the alliance created a community model for implementing the program.
“We utilize the Five Wishes for two reasons,” Plummer said. “The first one is Cottage Health System promotes it and we want to be consistent, but more important is that it is often referred to as the advanced health-care directive with a heart. It’s a really good catalyst for those conversations; the last question, for example, is what do you want your loved ones to know before you die?
“It’s paradoxically life affirming,” she continued. “We created a model that tries to make it more comfortable and safer for people to have these kinds of conversations, recognizing that it’s not easy.”
The alliance goes into places like retirement facilities, churches and workplaces (Cottage Health System, Sansum Clinic and Santa Barbara County have participated) to make presentations and “train people in those communities to help with the presentation whenever possible,” said Plummer, adding that “It’s just that much more comforting to have someone you know.”
More than 200 people are now trained to assist with the Five Wishes and that number is growing. The Latino population is a large focus of that effort and a generous grant from the Archstone Foundation has enabled the alliance to bring aboard a bilingual, bicultural outreach coordinator.
The alliance is also putting on other events, such as a recent film series, to promote the cause. Coming up June 24-26 is a La Casa de Maria retreat program called “Befriending the Unknown: Courage in Community.” Based on the work of Parker J. Palmer, the program is designed for people committed to experiencing, learning about and eventually leading a small group that follows the principles and practices of circles of trust processes.
“The idea is, again in community, we have a 10-week curriculum for people to explore some pretty big questions in life with others,” Plummer said. “We’re recruiting right now.”
Coincidentally, Plummer is the author of a book called Deep Change: Befriending the Unknown, whose title predates her work with the alliance.
“I have always been very interested in transition,” said Plummer, who has a master’s degree in social welfare from UC Berkeley, specializing in community organizing and planning. “Whether it’s grief or other kinds of deep change in our life, that’s what really draws me.”
“Then I went back to graduate school to get my doctorate in psychology and ended up doing research on this experience of deep change. I didn’t know what I was doing at the time, but it turned out to be very descriptive and navigational, and helping a lot with my clients.”
Plummer says she joined the Alliance for Living and Dying Well because “the mission really stirred me.”
“I enjoy having meaningful conversations with friends and sharing the stories of life,” she said. “Some people believe that being more conscious of the eventuality of death is a morbid, life-denying proposition. But actually, the opposite is most often the case.
“When we are more aware in our daily life that we will not live forever, we tend to live more fully. We feel more vividly the preciousness of life, what really matters, and experience a deeper sense of connection with life around us.”