End-Of-Life Agenda

TOUGH CONVERSATIONS and a plan for dying can ease loved ones’ pain when the time comes

By Lexi Reich

WHEN WAS THE LAST TIME you seriously thought about or talked with a family member or close friend about dying? As human beings, we often shy away from discussing the inevitable end of our lives. However, various Colorado professionals believe embracing this topic and making thoughtful preparations can bring peace of mind not only to ourselves but also to our loved ones. There are numerous aspects to explore when it comes to end-of-life care, from the role of death doulas to pre-planning funeral services, plus understanding medical options. And remember: There’s no rule that says this must be a sad topic. It can be empowering to take control of this one final act.

Death doulas, also known as end-of-life doulas or death midwives, play a crucial role in providing non-medical emotional, spiritual and informational support to individuals facing a life-limiting illness and their families. Vanessa Johnston, founder of Denver EOL Doula and vice president of the Colorado End-of-Life Collaborative, says she discovered her calling through caring for a friend with ALS. “So many people say, ‘I don’t want to be a burden on my family’ so they avoid the conversation altogether, but the burden comes when no one is willing to talk about end-of-life preferences while they’re alive,” Johnston says. “It’s a gift to your friends and family if you talk about—and better yet, write down—what you want regarding medical care if you can no longer communicate and final disposition, at the very least.”

Death doulas guide individuals through various stages, from advance care planning to final disposition information. Their goal is to shift perspectives from fear and anxiety to love and meaning, allowing individuals to embrace a conscious dying experience. By normalizing conversations about death and empowering individuals to articulate their end-of-life preferences, death doulas facilitate a more compassionate and informed approach to dying.

Kim Burnett, a Denver-based death doula, after-loss professional and owner of Good Death Matters, brings a wealth of expertise and emphasizes the role adult children can play in helping aging parents prepare before it’s too late. She advocates for open dialogue surrounding end-of-life care. Children can help parents document their wishes through meaningful conversation. Burnett’s approach centers on alleviating logistical burdens, allowing families to focus on the emotional aspects of grief and closure.

“I came to this work in 2020, when, over the course of a year, I found myself helping both a good friend and my mom prepare for death. Initially, they asked for help navigating the logistics of death—the endless paperwork; whether to bury, cremate or donate their bodies; memorial planning; and communicating with friends and family,” Burnett shares. Her more than two decades of experience as an event planner and project manager enabled her to embrace the tasks and they felt comfortable to her, even within this new context. “When the weight of the details was lifted from them,” she says, “I witnessed a transformation as each of them had the time to be present with those they loved—to grieve, find closure and truly honor their life in their last days together.”

Burnett understands that discussing end-of-life matters with aging parents can be challenging as they may be reluctant to talk about it. She says one approach is to share your own plans and ask them about theirs, which shows your willingness to help them. “If they continue to resist, be respectful of that choice, but let them know why you want to know what their wishes are and why you want to help them prepare,” she adds. “Expressing how you feel, what you worry about and how they can help comfort you by taking the time to do this can often be the key.”


As the president of Newcomer Funeral Service Group, John Newcomer champions the importance of pre-arranged funeral services in the Denver metro area. He says pre-planning funeral services not only provides peace of mind but also offers price protection, allowing individuals to lock in today’s prices and spare their loved ones from potentially higher costs in the future. The process involves meeting with advance planning specialists to discuss options, documenting preferences and determining funding arrangements. 

Newcomer emphasizes that while the thought of pre-arranging funeral plans may seem daunting, many individuals find relief in knowing that their wishes are documented and their loved ones are supported.

As a death doula, Johnston informs her clients about options such as voluntary stopping of eating and drinking (VSED), permitted nationwide, and Medical Aid in Dying (MAiD), which is available in 10 states including Colorado. Additionally, she highlights ecological after-death alternatives like green burial, water cremation and natural organic reduction, suggesting exploration based on legality within their state.

The Colorado End-of-Life Options Act enables eligible individuals—those with a terminal diagnosis and a prognosis of six months or less—to access medication to voluntarily end their lives. Denver Health’s MAiD program provides holistic support and ensures access to resources for patients and their families. Katie Sue Van Valkenburg, the program coordinator, emphasizes the importance of education and accessibility in increasing awareness and usage of MAiD. The fact that this can certainly be a hot-button topic for many, is proof that it’s important to have the hard conversations early, and possibly to revisit the topic repeatedly at different stages of life.

Contrary to misconceptions, Van Valkenburg says MAiD is considered a natural death (and would be stated as such on the death certificate), and individuals have the autonomy to decide whether to proceed with the medication. While coverage by Medicare/Medicaid and most insurances is limited, Denver Health offers financial assistance and bereavement services to support patients and their families throughout the process.

“I always remind people that MAiD is just one of the many decisions people contemplate—and at the end of the day, it is always just an option,” she says. “That’s why it’s called the End-of-Life Options Act.”



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