Lashanna Williams shared her story in February of 2024.

I wasn’t grown with people who planned for death. Death was just something that happened. 

It wasn’t until I was well into my 30s and volunteering for a hospice that I even started to think about advance care planning. It was the discovery of this information that shifted my thoughts on planning. It was like, who knew? 

Then I became further interested in the end-of-life community when I found out about death doulas. A friend who lives in Alaska was visiting and asked if I wanted to join her and our mentor for a birth doula course. I did not. But, I did want to spend time with my out-of-state friend. I told her, “I have no interest in being a birth doula. I will never, ever put these skills to use. I just want to kick it with you.” Our mentor responded, “Good. No offense, Lashanna, but I would never hire you as a birth doula.” 

Our mentor asked if I had heard about death doulas. I had not; I asked her to tell me more. She didn’t have much information, but she shared a website of a Washington-based organization where I could learn more. Soon I was taking classes two hours north of my home from the founder of A Sacred Passing, the nonprofit I now head. I studied under her and eventually offered her my massage studio as a space for teaching doula classes so that people in my community could access this information. Then one day she told me she was leaving her position to become a nurse. She practically handed over the nonprofit to me.

Five years later, we’ve done amazing things. We were given a wonderful seed to start with, but the education was rooted in dominant cultural norms. It didn’t necessarily speak to the way in which I would like to be cared for; it was one way for people to be cared for at the end of life. So our board thought through different ways to care for people, and we rewrote the curriculum. We’ve rewritten it three times in five years. It’s wonderful. And it’s accessible. People don’t have to participate in ways that are uncomfortable or inaccessible to them. Our root is community care, and when you work with a community there is no one way to do things.

Being embedded in this work, I talk about it with everybody. For example, my kids have had their death plans since they were teenagers. The funniest insight to come from that is how much they distrust my fashion sense. They both made their wishes clear: “Do not let Mom dress us.” Now young adults, they appreciate the ways in which this thought and care improves community health and well-being.

The American medical world is on a live-longer train, not a science train. We all die. Why we don’t talk about it and talk about it with our medical professionals is wild. It’s so unhealthy. It’s unhealthy for us. And it’s unhealthy for them.

To prompt a casual conversation, I ask people what I call “if you give a mouse a cookie questions.” Questions like: When you think of the end of your life, what are some things that would comfort you? If you had to have one taste in your mouth at the end of your life, what flavor would it be? If you could pick one song to listen to on repeat and you couldn’t change it, what song would you choose?

Planning is so important, yet it’s the biggest hurdle. A lot of people who have access to planning have material possessions to plan around and that they want to protect. But for many, their lives aren’t about material possessions. Yes, they have some, but that’s not the biggest planning aspect for them.

Often, planning programs focus too much around what people don’t have — property, 401(k)s, stocks and bonds, or other assets. This can confuse, intimidate and other people. It can make people feel like: Should I have all this stuff? Why don’t I? Am I doing the wrong thing? Did I not do it right because I don’t have these things to bequeath to the people who love me?

It takes time to thoroughly explain things instead of reading it off a paper, and to ask people: What are your concerns? When you think about time as you age, what is important to you? The words that we use in these conversations are so important, and leaving room for people to articulate how they identify and presenting them with different ways for them to express what they want is essential.

Being introduced to end-of-life planning much earlier could also make it easier for people to navigate decisions. If all people grew up learning their options for end-of-life and after-death care, that would be different, but people often don’t get that understanding. Ideally, if you get a license to drive a vehicle, that should be the first time you complete an advance directive. Accidents happen. Death and dying aren’t old-person things. Humans die at all ages.

Having these conversations more often can, I don’t want to say normalize, but soften the way you receive this information. Death doesn’t have to be this thing with super sharp edges all of the time. When you think about it and have made time to plan, it can be softer. The bravery to plan is a big deal. It’s a hard thing to do, especially in communities where your association with death is regularly super traumatic, violent, or drug- or alcohol-abuse related. Planning a death isn’t something you want to see when your association with death is all of those things. Death planning in the communities I’m from is a dare to dream. 

We’ve worked hard to become a solid throughline of providing death care and education. But we are painfully clear that no one can roll into a “good” death after a hard, under-resourced life. That just doesn’t equate.

In an effort to ensure people have a safe and supportive space in Washington state to exercise their choice to use medical aid in dying and voluntarily stop eating and drinking at the end of life, we created an initiative called A Place to Die. Sadly, though both options are allowed in Washington, some hospitals, hospice facilities, care homes and living centers have rules that do not support a person exercising their legal right to choose. A Place to Die gives community members access to information, death doula care and a physical place where any person can stay while exercising their end-of-life choice.

There are small things we can all do to help our loved ones and community members start to think about advance care planning in a more positive light and engage in this topic early. When you get a chance to talk with the people who are important to you about what you want when you are unable to care for yourself, that’s vulnerability. And to share that with people is trust and love building. It’s part of what gets us out of this unfathomable mess of death denial.