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The Commons
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Taryn Heon/The Commons

Joanna Rueter thinks everyone should have an Advance Care Planning document, so that family members and medical personnel know how end-of-life health care and death are to be managed.

News

Talking directly about death

Taking Steps Brattleboro leads week-long event to raise awareness about Advance Care Planning

Originally published in The Commons issue #403 (Wednesday, April 12, 2017).



BRATTLEBORO—Joanna Rueter, the Advance Care Planning coordinator at Brattleboro Area Hospice, joked in an interview about others’ perceptions of the nature of her work.

Her expertise? Death.

“We joke in my house about what I read,” she said, mentioning a book called Smoke Gets in Your Eyes: And Other Lessons from the Crematory by Caitlin Doughty.

The so-perceived “morbidity” of her career is unsettling and bewildering to many with whom she crosses paths. But this discourse is at the heart of her work: normalizing the discussion about death — a natural part of existence, and one that requires thoughtful, compassionate preparation.

One vital part of that preparation is to complete advance directives — plans for how one would like their end-of-life health care and death to be managed.

“Every single adult should have an advance directive,” Rueter said, “and an awful lot of them don’t. Young people in particular often think that it’s only for elderly people.”

From Apr. 17 to Apr. 23, Rueter and Brattleboro Area Hospice’s Taking Steps Brattleboro will host Advanced Care Planning week in Brattleboro at various community sites. Their hope is to create an opportunity for people to learn about advance directives and planning — but also to put the topic of death out in the open.

For Rueter, the topic of death as the focus of her career has, in part, evolved out of her prior careers — work relevant to all stages of life.

Her career aspiration, in myriad roles, has always been to “make whatever you have as good as possible.”

This involves not just addressing clients’ difficulties but also acknowledging their strengths and resources. She has practiced this in a variety of venues — from Early Childhood education and day care management, to clinical social work with couples and families, to the founding of Breathing Space (a home and office organizing business), to canvassing and making phone calls for Barack Obama’s 2008 campaign.

Advance Care Planning involves consideration not only of death, but also, in large part, of quality of life. Rueter considers the question: How does one make a life, with the circumstances and resources one has, as good as possible?

In working to optimize circumstances for people at Brattleboro Area Hospice, Rueter takes an open and honest approach.

“I ask people [during end-of-life planning], ‘What, to you, is a good day?’” Rueter said.

This is to learn where clients draw the line between continuing care and deciding to end treatment because their quality of life and their “best” days don’t meet their expectations. It is to hear, plainly, at what point someone is ready to die.

Rueter’s work at Brattleboro Area Hospice is largely informed by an internationally recognized, evidence-based model of advance care planning called Respecting Choices.

In 2015, a grant was offered to kick-start Taking Steps Brattleboro, and since then Rueter has trained three teams with the Respecting Choices curriculum, with 18 trained volunteers.

“Currently, 256 people have called ... since the practice started. Out of those, right now, 139 have completed their directives. And 111 of those are registered,” she said.

Rueter explains that part of the passion behind her work is driven by her own personal experience. With the death of several family members occurring around the same time, Rueter said, “I saw how there was ... a protecting of their ability to die peacefully” — a safeguard she now seeks to offer others as well.

Opportunities to learn more about ACP are available in mid-April. Taking Steps Brattleboro will offer the following free events from noon to 1 p.m. each day at the River Garden at 157 Main St.:

• Monday, April 17: Suzanne Weinberg speaks on “Who’s Your Person? Choosing an Agent: How do you do that?”

• Tuesday, April 18: Hannah Thurber leads a discussion on “Advance Care Planning for Those Under 35 — Why me, why now?”

• Wednesday, April 20: The River Garden hosts “What is Living Well to Me? (An Interactive Exploration).”

• Thursday, April 20: “Advance Directives Discussion for Men” with Don Freeman.

• Friday, April 21: “What Does it Take to Be a Healthcare Agent?” with Edie Mas.

The week concludes with two special events.

• Saturday, April 22 (Earth Day), at 2:30 p.m.: “A Will for the Woods,” the story of one man’s quest for Green Burial, at the Meeting Room of the Brooks Memorial Library, 224 Main St.

• Sunday, April 23, at 4 p.m.: “Defending Your Life,” an afterlife comedy starring Meryl Streep and Albert Brooks, at The Latchis Theatre, 50 Main St.

In conjunction with these events, there will be free information tables in various locations throughout the town:

• April 17, 18, and 20 at the Brattleboro Food Co-op, 11 a.m. to 1 p.m.

• Apr. 18, 19, 20, and 21 at the Richards Building Lobby at Brattleboro Memorial Hospital, 11 a.m. to 1 p.m.

• Apr. 19 at the Brattleboro Food Co-op, 11 a.m. to 1 p.m. and 4 to 6 p.m.; and at the Brattleboro Senior Center, 207 Main St., 11:30 a.m. to 1 p.m.

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