The Conversation

By the Alameda County Health Care Services Agency

A “senior tsunami” threatens to overwhelm the healthcare system. Baby-boomers, born between 1946 and 1964, will create an unprecedented demand for palliative and end-of-life care services over the next 30-40 years. Many professionals say it is happening now. Neither the private nor public sector has the capacity to cope.

The over-60 age group will grow by 170 percent by 2030. The average life span has increased by 30 years in the last century. Seventy-nine percent of people receiving long-term care live at home and not in institutions. Sixteen million families will care for their children and/or disabled family members and aging parents, too. Longevity is accompanied by fears of insufficient and/or unwanted treatment at the end of life. People are not dying in the manner they would choose.

The Alameda County Health Care Services Agency wishes to implement systems to deal with end-of-life care before the senior tsunami begins. The Agency’s hospice project, Getting the Most OUT OF LIFE (GMOL), is a partnership with for-profit and non-profit palliative care and hospice providers serving County residents. The coalition aims to engage families in low-cost and free services concerning end-of-life care and planning for the future. A secondary goal is to increase awareness and use of hospice services by the elderly, terminally ill and medically frail and to explore ways to augment service delivery in a culturally-sensitive manner.

GMOL, facilitated by Alameda County Hospice Services Coordinator Marilyn Ababio, has launched The Conversation campaign to promote discussion about end-of-life care issues. In America, it is never easy to discuss or deal with death but not talking about it does not make it easier. Not having a plan can make matters more difficult when loved ones pass.

The Conversation is about what matters to you, not what is the matter with you. The campaign does not promote any preference for end-of-life care but guides and encourages people to consider, communicate and document their critical care preferences using an Advance Health Care Directive (AHCD) and/or the Physicians Order for Life Sustaining Treatment (POLST) long before a medical crisis occurs.

According to the 2012 California Healthcare Foundation Survey, 60 percent of people agree it is “extremely important” not to burden their family with tough decisions but 56 percent have not communicated their end-of-life wishes.

Seventy percent of interviewees say they would prefer to die at home but 70 percent of all deaths occur in a hospital, nursing home or long-term care facility.

Eighty percent of respondents feel they would want to discuss end-of-life care with their doctor, if seriously ill, but only seven percent have had this conversation. Also, 92 percent reported their doctors had never broached the subject of end-of-life medical treatment.

“Without an opportunity to discuss wishes and concerns, people are likely to hand over these often critical care decisions to clinicians and surrogates who may be poorly equipped to make those decisions,” says Ellen Goodman, Founder of

Alameda County is offering free Conversation Starter Facilitator training on Saturday, February 8 (9:30 a.m.-12:30 p.m.) and Thursday, March 6, 2014 (4:30-7:00 p.m.) at Alameda County Health Care Services Agency, 2nd Floor, 1000 San Leandro Blvd., San Leandro. Register for one of the training days by sending contact details to Free on-site training for groups of 15, or more, can be scheduled by contacting

On National Healthcare Decisions Day (April 16, 2014), multiple events will occur throughout the County, celebrating our volunteers and supporters and further engaging the public on advance care planning topics. Scheduled events are: Expo and program at the Henry J. Kaiser Center, Oakland, CA; and Death Café at Suju’s Coffee, 3602 Thornton Ave., Fremont, CA.

Connect with us. LIKE our Facebook Page at, JOIN our Facebook Group Conversation Starters at and FOLLOW us on Twitter @ALCO_GMOL.

Hear more at

Conversation Starter Facilitator Training
Saturday, February 8
9:30 a.m. -12:30 p.m.
Alameda County Health Care Services Agency
1000 San Leandro Blvd., 2nd Floor, San Leandro

Conversation Starter Facilitator Training
Thursday, March 6
4:30 – 7:00 p.m.
Alameda County Health Care Services Agency
1000 San Leandro Blvd., 2nd Floor, San Leandro