Our MISSION: To help YOU and YOUR Loved Ones attain your end-of-life goals.

We try to reduce how long and how intense patients and their loved ones must suffer from any terminal illness, especially those living with Advanced Dementia.

We strive to provide an “ironclad” solution so no one will ever consider premature, preemptive suicide for themselves, or consider “mercy killing” for their loved one.

One way to express this goal is

Plan Now, Die Later®—to Live Longer

Caring Advocates consists of a team of clinical, legal, and pastoral professionals who are dedicated to help people attain private, peaceful, and timely transitions.

We offer Advance Care Planning that includes:

  • A unique patient decision aid—My Way Cards—that facilitates making decisions that reflect your values,
  • An end–of–life intervention—Natural Dying—designed to be both effective and acceptable to those in authority, and
  • Strategies that will motivate physicians and others to honor your end–of–life wishes or those of your loved ones.

In addition to planning, we offer active professional help in the final chapter of people’s lives.

We offer two Protocols for two kinds of people:
 Strategic Advance Care Planning is for people who still have the mental ability to make treatment decisions.  
 Now Care Planning is for patients who have already reached the stage of Advanced Dementia but lack an adequate or effective living will.  


The Natural Dying Living Will is Unique:

 Compelling: Severe enough suffering is the single criterion used to determine when patients want to die of their underlying disease.
 Comprehensive: Patients (or their proxies/agents) judge over four dozen conditions that include what people dread most about prolonged dying in advanced dementia and other terminal illnesses.
 Easy to complete: Illustrated and written at the 4th grade of reading comprehension, My Way Cards can be used by many patients in early dementia to make judgments about future possible conditions.
 Straightforward to interpret: Physicians do NOT need to assess patients’ current suffering. Instead, physicians only need to determine if patients have reached a clinical condition that patients had previously judged would cause SEVERE ENOUGH SUFFERING for them to be allowed to die of their underlying disease.
 Acceptable: The intervention “Natural Dying” (as explained) aspires to be accepted by authorities who view it as legal, ethical, moral, and consistent with the teachings of conservative religions.
 Respectful: Avoids conflict that could lead to either prolonged or premature dying by:
(A) The interpretation of observed feeding behavior can lead to mistakes and either premature or prolonged dying;
(B) Use of “stage of disease” can be arbitrary and/or irrelevant;
(C) Physicians imposing what they believe is in patients’ “Best Interest” can be paternalistic and not reflect patients’ values; and,
(D) Relying on such vague terms as “indignity” and “quality of life” could be ambiguous and lead to prolonged conflict, or worse: it could begin a dangerous slippery slope where one group of people assumes they have the right to judge if the lives of other people are worth living.
 Effective: Strategies can be added that strive to overcome more than 14 common challenges, rather than assuming—or hoping—that others will honor patients‘ clear and specific wishes.

My Way Cards examples

For Most:
No Suffering

For Most:
Severe Enough Suffering

Condition 0.0 Condition 8.3
Condition 3.3 Condition 3.3

People’s judgments vary

Condition 4.5 Condition 5.5

 


Is your (or your loved one’s) living will adequate, effective, and easy to understand and complete?

Caring Advocates offers this time-limited, free service:
Send us your living will so we can offer our opinion.
Email your form to Dr. Terman: livingwillsdementiaetc@gmail.com
Or FAX your form to 888-767-6322

Natural Dying versus MAiD or Medical Aid in Dying (Physician-Assisted Suicide):

A) Natural Dying does not actively cause patients' dying. Instead, patients die of their underlying disease. Example: patients die from severe impairment of mental functioning due to their brain disease, Advanced Dementia. (The physician orders for Natural Dying include stop assisting hand-feeding and hand-hydrating, but always offer food and fluid by placing them in front of patients and within patients’ reach.)

B) Natural Dying does not require alert patients to make a one–time, irreversible decision. Instead, you can change your mind after fasting for a few days;

C) Natural Dying and VSED (Voluntarily Stopping Eating and Drinking) are legal almost everywhere and do not necessarily depend on finding a physician who is willing;

D) MAiD—even where legal—cannot let patients die after they reach Advanced Dementia. Why? Two reasons: Patients usually live longer than 6 months, and their minds are not sound enough to make this extremely important decision: Do they want to continue to live in the face of severe suffering?

But you can request Natural Dying in your Living Will. Strategic Advance Care Planning lets you make this request clear, consistent, convincing, and compelling.

 

More about Natural Dying

Natural Dying works even for patients who have “No Plug to Pull”; that is, for those whose living does not depend on treatment beyond spoon–feeding.

Natural Dying—especially if you add the recommended strategies—can effectively overcome challenges and avoid conflict after you reach Advanced Dementia, or another terminal illness, so you can have a private, peaceful, and timely dying.

General information:

Both Protocols are protected by trademarks, copyrights and applications for patents pending with the USPTO.

Professional fees are typically covered in part by Medicare and other health insurance policies. Our staff can help estimate your cost.

We offer HIPAA-Compliant Internet Video chatting, if you prefer to not travel to our offices.

Click here if you prefer to try a free excerpt of the online decision aid before selecting one of our packages.

(If you are a professional or just prefer full explanations, click here instead.)

Dr. Terman has accurately and respectfully presented the Catholic position(s). I agree with the values he holds most dear: To do everything possible to learn directly from the patient what she or he wants; and to appreciate that one of life’s greatest joys—to be heard and respected—is especially true for needy and vulnerable patients in the last chapter of their lives.

John Gillman, Ph.D., ACPE Supervisor of Clinical Pastoral Education; VITAS Innovative Hospice Care, San Diego, California